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Sample records for trimester nuchal translucency

  1. Intracranial translucency assessment at first trimester nuchal translucency ultrasound.

    Science.gov (United States)

    Lane, Annah; Lee, Ling; Traves, Donna; Lee, Andreas

    2017-04-01

    The antenatal diagnosis of open spina bifida (OSB), a neural tube defect, is predominantly made at the second trimester morphology scan by ultrasound detection of structural abnormalities resulting from the associated Chiari II malformation. Evidence has emerged suggesting that these structural abnormalities can be detected earlier, by examination of the posterior fossa as part of the first trimester nuchal translucency scan. In particular, absence of the intra-cranial translucency (IT) of the fourth ventricle has shown promise as a diagnostic marker of OSB, although the sensitivity and specificity of this finding varies widely in the literature. The aim of this study is to assess the feasibility of obtaining the image of the IT at our institution as part of the routine first trimester scan. This is a prospective study of 900 obstetric patients who presented to a tertiary women's imaging centre for routine first trimester nuchal translucency screening ultrasound for the year 2014. Their risk status was that of the general population (low risk) prior to presentation. A total of 158 patients were excluded, leaving a study group of 742. Sonographers obtained a mid-sagittal view of the fetal face with particular focus on optimum viewing of the IT. All images were examined by a Radiology Registrar for presence or absence of IT. Duration of each scan was documented. The IT image was successfully acquired in 94.9% of scans. Maternal pre-pregnancy BMI and fetal lie were shown to have a statistically significant effect on success of acquisition of the IT image. No cases of OSB were diagnosed during the study. Scan times were not lengthened by the addition of the image. We consider that acquisition of an image of the IT as part of the routine first trimester nuchal translucency scan is feasible, without lengthening appointment times. © 2016 The Royal Australian and New Zealand College of Radiologists.

  2. Monosomy 18p presenting with holoprosencephaly and increased nuchal translucency in the first trimester: report of 2 cases.

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    Sepulveda, Waldo

    2009-08-01

    The purpose of this series is to describe the first-trimester sonographic findings leading to the diagnosis of monosomy 18p. The sonographic appearance of 2 cases of monosomy 18p, detected as part of first-trimester sonographic screening for aneuploidy at this institution, was reviewed. Increased nuchal translucency thickness, alobar holoprosencephaly, and facial defects were detected in both cases. Chromosomal analysis by chorionic villus sampling revealed de novo del(18p) in 1 case and monosomy 18p as the result of an 18q isochromosome in the other. Increased nuchal translucency thickness in association with brain and face anomalies on a first-trimester scan allowed the early diagnosis of monosomy 18p. Fetuses with holoprosencephaly can be readily identified in the first trimester by examining a cross section of the fetal head looking for the "butterfly" sign. Prenatal karyotyping provides important information regarding the etiology and risk of recurrence in these cases.

  3. Quality Assessment of Fetal Nuchal Translucency Measurements in the First Trimester of Pregnancy

    Czech Academy of Sciences Publication Activity Database

    Hynek, M.; Stejskal, D.; Zvárová, Jana

    2011-01-01

    Roč. 7, č. 1 (2011), s. 22-32 ISSN 1801-5603 Institutional research plan: CEZ:AV0Z10300504 Keywords : nuchal translucency * control chart * statistical process control * cumulative sum * exponentially weighted moving average * prenatal screening Subject RIV: IN - Informatics, Computer Science http://www.ejbi.eu/images/2011-1/Hynek_en.pdf

  4. The Relationship between Thickness of Nuchal Translucency and Down Syndrome in the First Trimester of Pregnancy

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    Mohsen Hasanzadeh

    2012-04-01

    Full Text Available Background: Various anomalies, especially Down syndrome impose heavy emotional and financial burden on families and communities by development of mental and behavioral retardation. The purpose of this study is to assess the value of Nuchal Translucency (NT to diagnose Down syndrome in the first trimester of pregnancy.Materials and Methods: This prospective study was conducted through evaluating 102 pregnant women of 17-44 years old with gestational age of 11 to 13 weeks and 3 days, in a private radiology clinic in Zahedan during May 2008 to June 2010. All embryos were ultra-sounded by a radiologist, their NT and crown-rump length were measured. After birth, all infants were examined by a pediatrician and cases suspected with Down syndrome were diagnosed through karyotype test.Results: The mean of NT was 1.62 mm. NT was above 1.7 mm for women older than 35 years and it was 3.1 to 3.8 mm for women older than 40 years. 6 out of 7 cases diagnosed postnatal with Down syndrome, had above 95% normal NT and 4 out of 7 mothers who had baby with Down syndrome, were older than 35 years.Conclusion: Through measurement of NT during 11th to 13th weeks of pregnancy and consideration of base risk factors, the possibility of Down syndrome can be assessed and necessary diagnostic evaluations can be performed for risky cases.

  5. Absence of an anatomical origin for altered ductus venosus flow velocity waveforms in first-trimester human fetuses with increased nuchal translucency

    NARCIS (Netherlands)

    Burger, Nicole B.; Matias, Alexandra; Kok, Evelien; de Groot, Christianne J M; Christoffels, Vincent M.; Bekker, Mireille N.; Haak, Monique C.

    2016-01-01

    Objective: To perform a morphological evaluation of the ductus venosus, heart and jugular lymphatic sac (JLS) in first-trimester human fetuses with normal and abnormal ductus venosus flow velocity waveforms (DV-FVWs) and normal and increased nuchal translucency (NT). Method: Postmortem examination

  6. Nuchal translucency beyond Down syndrome screening

    NARCIS (Netherlands)

    Timmerman, E.

    2013-01-01

    Nuchal translucency (NT) goes far beyond Down syndrome screening. An enlarged NT is associated with a wide range of structural and genetic anomalies. A detailed first trimester scan is an important step in screening for those anomalies and in individual risk assessment. All pregnant women should be

  7. Does diurnal variation affect the first trimester fetal aneuploidy screening test biochemical parameters of fetuses with normal nuchal translucency?

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    Karsli, Mehmet Fatih; Cakmak, Bulent; Seckin, Kerem Doga; Akkas Yilmaz, Elif; Akgul, Gurcan; Togrul, Cihan; Kucukozkan, Tuncay

    2016-01-01

    The purpose of this study was to investigate the effect of diurnal variation on biochemical results of first trimester aneuploidy screening test. A total of 2725 singleton pregnant female, who had normal fetal nuchal translucency (NT) thickness, were included in the study during this period. Individuals were divided into two groups according to the sampling time (morning group: 09:00-11:00 am and afternoon group: 02:00-04:00 pm). Hormonal parameters (free-beta human chorionic gonadotropin [free β-hCG] and pregnancy-associated plasma protein-A [PAPP-A] multiples of median [MoM] levels) of first trimester (11(+0)-13(+6) weeks) combined aneuploidy screening test were compared between morning and afternoon groups. PAPP-A MoM levels were significantly lower in the afternoon group when compared to the morning group (p = 0.001), whereas free β-hCG MoM levels were similar in the both groups (p = 0.392). Rate of high risk for Down syndrome (Combine risk >1/300) and amniocentesis ratio were found higher in the afternoon group than morning group, but there were no difference between groups for the number of fetuses with Down syndrome. Receiving the venous blood sample for first trimester aneuploidy screening test in the afternoon causes low PAPP-A MoM levels.

  8. Obstetric outcomes in pregnancies with normal nuchal translucency and abnormal ductus venosus Doppler in the first trimester ultrasonography.

    Science.gov (United States)

    Seckin, K D; Karslı, M F; Baser, E; Yeral, M I; Tasin, C; Ozgu Erdinc, A S; Danisman, N

    2016-05-01

    In the present case-control study, we evaluated obstetric outcomes of pregnancies with normal nuchal translucency (NT) and abnormal ductus venosus (DV) Doppler findings in the first trimester combined screening test for chromosomal abnormalities. All study patients underwent DV Doppler examination, concurrent with the combined screening test. DV Doppler revealed pathologic findings in 14 pregnant women despite normal NT after the elimination of lost to follow-up and foetal anomaly. Obstetric outcomes of the case patients were compared with a control group that were matched for mean gestational age, and Crown-rump length with normal NT and DV Doppler measurements was selected comprising 88 pregnant women. Regarding maternal outcomes, women with abnormal DV Doppler findings had a higher rate of placental abruption, delivered at an earlier mean gestational age (preterm delivery). Interestingly, a higher rate of spontaneous vaginal delivery rate was observed in these patients. From the foetal perspective, pregnancies with abnormal DV Doppler had lower birth weight and received lower Apgar scores. In conclusion, an abnormal DV Doppler test in the first trimester was associated with poor maternal and foetal obstetric outcomes. These findings should be elucidated in future studies.

  9. Increased nuchal translucency, normal karyotype and infant development

    DEFF Research Database (Denmark)

    Miltoft, Caroline Borregaard; Ekelund, Charlotte Kvist; Hansen, Bo Mølholm

    2012-01-01

    To investigate whether chromosomally normal fetuses with a nuchal translucency (NT) = 99th percentile(3.5 mm) in the first trimester have an increased risk of delayed development at 2 years of age....

  10. Normal reference range of fetal nuchal translucency thickness in pregnant women in the first trimester, one center study

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    Marzeie Sharifzadeh

    2015-01-01

    Full Text Available Background: Considering that establishment of reference value of nuchal translucency (NT-related to the crown rump length (CRL during the first trimester will be helpful for determining an appropriate cutoff level for screening of increased NT thickness-related abnormalities, we determined the NT thickness and investigated its relation with different chromosomal and nonchromosomal abnormalities among a large sample size of pregnant Iranian women. Materials and Methods: In this analytic cross-sectional study, pregnant women who were in their first trimester were enrolled at their antenatal visit. Using an abdominal ultrasonography, the fetal NT thickness of the studied population was measured. Those with increased NT thickness were determined. The reference value of NT thickness (5th, 25th, 50th, 75th, and 95th percentiles within each 5-mm range of CRL and during the 11th, 12th, and 13th gestational weeks were determined. The presences of the different chromosomal and nonchromosomal abnormalities were compared in women with different percentiles of NT thickness who underwent amniocentesis and those who did not. Results: 1,614 pregnant women were evaluated. The mean NT thickness was 1.30 ± 0.54 mm. Increased NT thickness >2 mm and >95th percentile according to their gestational age (GA was detected in 89 (5.5% and 58 (3.6% pregnant women. The reference 95th percentile value range for NT was 1.8-2.35 and increased NT thickness according to our obtained values was associated significantly with chromosomal abnormalities. Conclusion: The obtained reference range in our studied population was different from that reported for other ethnic groups and it is suggested that using this values are more favorable for screening of chromosomal abnormalities during the first trimester of pregnancy than the recommended single cutoff value.

  11. Normal reference range of fetal nuchal translucency thickness in pregnant women in the first trimester, one center study

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    Sharifzadeh, Marzeie; Adibi, Atoosa; Kazemi, Kimia; Hovsepian, Silva

    2015-01-01

    Background: Considering that establishment of reference value of nuchal translucency (NT)-related to the crown rump length (CRL) during the first trimester will be helpful for determining an appropriate cutoff level for screening of increased NT thickness-related abnormalities, we determined the NT thickness and investigated its relation with different chromosomal and nonchromosomal abnormalities among a large sample size of pregnant Iranian women. Materials and Methods: In this analytic cross-sectional study, pregnant women who were in their first trimester were enrolled at their antenatal visit. Using an abdominal ultrasonography, the fetal NT thickness of the studied population was measured. Those with increased NT thickness were determined. The reference value of NT thickness (5th, 25th, 50th, 75th, and 95th percentiles) within each 5-mm range of CRL and during the 11th, 12th, and 13th gestational weeks were determined. The presences of the different chromosomal and nonchromosomal abnormalities were compared in women with different percentiles of NT thickness who underwent amniocentesis and those who did not. Results: 1,614 pregnant women were evaluated. The mean NT thickness was 1.30 ± 0.54 mm. Increased NT thickness >2 mm and >95th percentile according to their gestational age (GA) was detected in 89 (5.5%) and 58 (3.6%) pregnant women. The reference 95th percentile value range for NT was 1.8-2.35 and increased NT thickness according to our obtained values was associated significantly with chromosomal abnormalities. Conclusion: The obtained reference range in our studied population was different from that reported for other ethnic groups and it is suggested that using this values are more favorable for screening of chromosomal abnormalities during the first trimester of pregnancy than the recommended single cutoff value. PMID:26929762

  12. Clinical utility of nuchal translucency screening

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    Stefanovic V

    2014-10-01

    Full Text Available Vedran Stefanovic,1 Outi Äyräs,1 Marianne Eronen,2 Jorma Paavonen,1 Minna Tikkanen1 1Department of Obstetrics and Gynecology, Helsinki University Central Hospital, 2Health Department, The Social Insurance Institution of Finland, Helsinki, Finland Abstract: The term nuchal translucency (NT is used to describe the accumulation of fluid behind the fetal neck visible on ultrasound in the first trimester of pregnancy. In singleton and dichorionic twin pregnancies, increased NT thickness is associated with trisomy 21 and other aneuploidies, major fetal anomalies (especially congenital heart disease, and genetic syndromes. The pathophysiology and significance of increased or discordant NT in monochorionic twin pregnancies is more complex and is associated with twin-to-twin transfusion syndrome and other pregnancy complications due to monochorionicity. The long-term neurological outcome of euploid children without structural anomalies after increased fetal NT seems to be favorable. Proper counseling is essential in the screening process. Special attention should be paid to the assessment of NT screening quality control. Even in the era of arising possibilities for non-invasive fetal karyotype determination from maternal blood, the role of NT screening is far from over. The association of this phenomenon with aneuploidies is only one of its utilities in modern obstetrics. Keywords: nuchal translucency, screening, aneuploidy, congenital anomaly, counseling, obstetrics

  13. High macrosomia rate in healthy fetuses after enlarged nuchal translucency

    NARCIS (Netherlands)

    Timmerman, E.; Pajkrt, E.; Snijders, R. J. M.; Bilardo, C. M.

    ObjectiveThe aim of this study was to investigate the association of the first trimester screening variables nuchal translucency (NT), pregnancy associated plasma protein (PAPP-A), and free beta-human chorionic gonadotrophin (hCG) and birth weight, with a focus on the prediction of macrosomia.

  14. High macrosomia rate in healthy fetuses after enlarged nuchal translucency

    NARCIS (Netherlands)

    Timmerman, E.; Pajkrt, E.; Snijders, R. J. M.; Bilardo, C. M.

    2014-01-01

    The aim of this study was to investigate the association of the first trimester screening variables nuchal translucency (NT), pregnancy associated plasma protein (PAPP-A), and free beta-human chorionic gonadotrophin (βhCG) and birth weight, with a focus on the prediction of macrosomia. The database

  15. Impact of a shift in nuchal translucency measurements on the detection rate of first-trimester Down syndrome screening: A population-based study.

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    Fries, Nicolas; Salomon, Laurent J; Muller, Françoise; Dreux, Sophie; Houfflin-Debarge, Véronique; Coquel, Philippe; Kleinfinger, Pascale; Dommergues, Marc

    2018-01-01

    To assess the distribution of nuchal translucency (NT) measurements following a national policy without credentialing and its impact on first-trimester Down syndrome screening (DSS) detection rate. All first-trimester DSS data recorded in France (2010-2014) were collected by the laboratories in charge via an Internet database (https://www.bionuqual.org/echo.php). There was no minimal requirement for image quality to allow sonographers to enter the screening process. A subgroup of DSS with complete DS follow-up corresponded to 1614 sonographers. Based on the distribution of maternal age, DS detection rate was calculated and split as a function of the distribution of NT multiple of the median (MoM). Four thousand nine hundred forty-three sonographers performed 2,337,372 NT measurements. Median NT expressed in MoM was 0.83. Screenings with complete follow-up consisted of 197,417 screenings, in which DSS detection rates were respectively 70.4%, 70.9%, 79.4%, 87.7%, and 79.5% for the following median NT MoM ranges: 0.99 (trend χ = 12.21; P = .0158). In France, following a policy of quality assessment without standardized credentialing, the distribution of NT measurements did not fit the expected distribution. Down syndrome detection rate was 10% lower in screenings by sonographers with a median NT < 0.80 MoM. © 2017 John Wiley & Sons, Ltd.

  16. Outcome of fetuses with enlarged nuchal translucency and normal karyotype

    NARCIS (Netherlands)

    Bilardo, C. M.; Pajkrt, E.; de Graaf, I.; Mol, B. W.; Bleker, O. P.

    1998-01-01

    The aim of this study was to examine the relationship between nuchal translucency measurements and outcome of pregnancy with special regard to fetuses with an enlarged nuchal translucency and a normal karyotype. Fetal nuchal translucency measurements were performed on consecutive mothers attending

  17. Pathophysiology of Increased Fetal Nuchal Translucency Thickness

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    Chih-Ping Chen

    2010-06-01

    Full Text Available Increased fetal nuchal translucency thickness is associated with trisomy 13, trisomy 18, trisomy 21, Turner syndrome, other sex chromosome abnormalities, as well as many fetal anomalies and genetic syndromes. This article provides a comprehensive review of the cardinal proposed pathophysiology including altered composition of the extracellular matrix, abnormalities of the heart and great arteries, and disturbed or delayed lymphatic development.

  18. Quality assessment in prospective nuchal translucency screening for Down syndrome

    DEFF Research Database (Denmark)

    Wøjdemann, K R; Christiansen, M; Sundberg, K

    2001-01-01

    OBJECTIVES: To develop and apply a quality control system in a Down syndrome screening study using nuchal translucency as an interventional marker. METHODS: In a prospective Down syndrome screening study fetal nuchal translucency thickness was measured in 9236 of the 10 045 examined pregnancies....... For quality assessment two models were introduced: firstly, image-scoring evaluation of the nuchal translucency thickness measurements and secondly, establishment of the distributions of nuchal translucency multiples of the median over time and the influence of intervention. RESULTS: The observer variability...... evaluation of the distribution of the nuchal translucency multiples of the median seems to be a good method to assess the quality for a center and may also be used to identify individual examiners deviating from the mean performance. The image-scoring methods we introduced cannot be recommended for quality...

  19. Increased nuchal translucency thickness and risk of neurodevelopmental disorders

    DEFF Research Database (Denmark)

    Hellmuth, S G; Pedersen, L H; Miltoft, C B

    2017-01-01

    OBJECTIVE: To investigate the association between fetal nuchal translucency (NT) thickness and neurodevelopmental disorders in euploid children. METHODS: This study included 222 505 euploid children who had undergone routine first-trimester screening during fetal life. Children were divided...... spectrum disorders (ASD), cerebral palsy, epilepsy and febrile seizures was obtained from national patient registries. RESULTS: There was no excess risk of neurodevelopmental disorders among euploid children with first-trimester NT 95(th) -99(th) percentile. For children with NT > 99(th) percentile...... in the risk of cerebral palsy (OR, 1.91 (95% CI, 0.61-5.95), 0.47%), epilepsy (OR, 1.51 (95% CI, 0.63-3.66), 0.78%) or febrile seizures (OR, 0.72 (95% CI, 0.44-1.16), 2.65%). CONCLUSIONS: In a large unselected cohort of euploid children, there was no increased risk of neurodevelopmental disorders among those...

  20. Predictive value of increased nuchal translucency as a screening test for the detection of fetal chromosomal abnormalities.

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    Alexioy, Eleni; Alexioy, Eleni; Trakakis, Eftihios; Kassanos, Demetrios; Farmakidis, George; Kondylios, Antonios; Laggas, Demetrios; Salamalekis, Emmanuel; Florentin, Lia; Kanavakis, Emmanuel; Basios, George; Trompoukis, Pantelis; Georgiadoy, Lina; Panagiotopoulos, Takis

    2009-10-01

    The study aimed to estimate the incidence of increased nuchal translucency in the first trimester ultrasound scan results (cut-off limit 2.5 mm) and to evaluate the predictive value of increased nuchal translucency as a screening test for the detection of fetal chromosomal abnormalities. We used the ultrasound scan results of nuchal translucency evaluation and the results of chromosomal analysis of the invasive prenatal control performed as a result of increased nuchal translucency. We collected 2183 nuchal translucency ultrasound scans in which we detected 21 embryos with a pathologic value (0.96%). We collected the data of 168 cases of invasive prenatal control due to increased nuchal translucency from which 122 cases were found. A total of 122 cases of pregnant women undergone an invasive prenatal diagnostic method due to increased nuchal translucency, of which 11 fetuses were found with trisomy 21 (Down syndrome) (9%), 3 fetuses with trisomy 13 (Patau syndrome) (2.45%), 3 fetuses with monosomy 45XO (Turner syndrome) (2.45%) and 1 fetus with translocation (0.8%). The positive predictive value of the increased fetal nuchal translucency as a screening test for the detection of fetal chromosomal abnormalities based on the results of the chromosomal-genetic analysis of the invasive prenatal diagnostic procedures is 14.8%.

  1. Quality management of nuchal translucency ultrasound measurement in Australia.

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    Nisbet, Debbie; Robertson, Ann; Mannil, Blessy; Pincham, Vanessa; Mclennan, Andrew

    2018-02-22

    Nuchal translucency measurement has an established role in first trimester screening. Accurate measurement requires that technical guidelines are followed. Performance can be monitored by auditing the distribution of measurements obtained in a series of cases. The primary aim is to develop an accessible, theory-based educational program for individuals whose distribution of measurements at audit falls outside an acceptable range, and assess operator performance following this intervention. Operators whose nuchal translucency measurement distributions fall outside a normal range (38-65% above the median) were expected to undergo a teleconference tutorial. Accessible from anywhere in Australia, the one hour tutorials were run by a senior sonographer (to explain technical ultrasound aspects) and the audit program manager (to explain the audit process). In 2011, 83 operators attended the teleconference tutorials. Compared to a random comparison group of operators meeting standard in 2011, teleconference tutorial attendees were significantly more likely to: (i) operate in rural or regional, rather than metropolitan, centres (P = 0.001); (ii) be less experienced (P audit cycle and was maintained over subsequent years. The mean percentage of the study cohort reaching standard over the five-year audit was 77.8% which was not statistically different from the average for the comparison cohort of all other audited operators (79.3%; P = 0.61). Teleconference tutorials are a convenient, accessible and effective way to obtain immediate and sustained improvement in operator performance. © 2018 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  2. High macrosomia rate in healthy fetuses after enlarged nuchal translucency.

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    Timmerman, E; Pajkrt, E; Snijders, R J M; Bilardo, C M

    2014-02-01

    The aim of this study was to investigate the association of the first trimester screening variables nuchal translucency (NT), pregnancy associated plasma protein (PAPP-A), and free beta-human chorionic gonadotrophin (βhCG) and birth weight, with a focus on the prediction of macrosomia. The database of our Fetal Medicine Unit was searched for all singleton pregnancies, who underwent first trimester Down syndrome screening. Live born infants born at term without chromosomal or structural defects from non-diabetic mothers constituted the study population. Birth weight percentiles were corrected for gestational age at delivery, parity, and gender. Macrosomia was defined as birth weight ≥95th centile. We included 6503 fetuses. Multivariate analysis demonstrated that birth weight centile was positively correlated with NT multiples of the median (MoM), PAPP-A MoM, and maternal body mass index, and it was negatively correlated with smoking. An NT ≥95th centile was present in 315 fetuses (4.8%). Although median birth weight centile was not significantly different between cases with NT ≥95th centile and those 95th centile was more common (11% vs 7%) in the presence of NT ≥95th centile. Pregnancy associated plasma protein was elevated (≥95th centile) in 303 cases (7.9%). Median birth weight was higher (P56 vs P51, P = 0.03) in case of elevated PAPP-A compared with PAPP-A macrosomia rate in case of PAPP-A ≥95th centile (7.4% vs 6.3%, P = 0.07). Area under the receiver operating characteristics (ROC) curve for the prediction of macrosomia (birth weight ≥95th centile) by NT MoM, PAPP-A MoM, maternal body mass index, and maternal smoking was 0.64 (P macrosomia. © 2013 John Wiley & Sons, Ltd.

  3. Detection of Fetal Abnormalities Based on Three Dimensional Nuchal Translucency

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    Lai, Khin Wee

    2013-01-01

    Ultrasound (US) prenatal screening has been proposed as the most effective technique for Trisomy 21 early assessment. Assessment of Nuchal Translucency (NT) offers promising non-invasive method for fetal abnormalities detection up to 75%. Nevertheless, current clinician practice of NT examination by locating the sonogram calipers on 2D US image requires highly trained and competent operators by adhering to a standard tedious protocol; therefore it is prone to errors and hence it decreases the reliability in intra- and inter-observer repeatability. This Brief provides the basic knowledge regarding Trisomy 21 diseases and its existing detection methods. The restrictions and disadvantages of each method are discussed accordingly. Therefore, a non-invasive early detection method using 3D ultrasound reconstruction of Nuchal Translucency is introduced. This new method for 3D NT assessments has an edge over the previous 2D methods, and entails the composite function in visualizing the explicit internal marker struct...

  4. Nuchal translucency measurements are highly correlated in both mono- and dichorionic twin pairs

    DEFF Research Database (Denmark)

    Wøjdemann, Karen R; Larsen, Severin Olesen; Shalmi, Anne-Cathrine

    2006-01-01

    OBJECTIVES: To establish the distribution of serological and ultrasound first-trimester Down syndrome markers in twins and identify correlations of significance for risk calculation. METHODS: Nuchal translucency (NT), PAPP-A and betahCG data were extracted from 181 twin pregnancies (31 mono......- and 150 dichorionic) with a normal outcome. All pregnancies were consecutively and prospectively included and examined in the Copenhagen First-Trimester Study. The variance of the sum and the difference of log MoM NT values in twin pairs was used to calculate the correlation. RESULTS: The serological...... that the NT is influenced by placental and maternal factors specific for the particular pregnancy, for example, nutrient supply or vascularisation. The correlation may be useful to improve the precision of the prenatal risk assessment for Down syndrome in first-trimester twin pregnancies. The serological...

  5. Pregnancy outcome and nuchal translucency measurements in fetuses with a normal karyotype

    NARCIS (Netherlands)

    Pajkrt, E.; Mol, B. W.; Bleker, O. P.; Bilardo, C. M.

    1999-01-01

    The aim of this study was to examine the relationship between nuchal translucency thickness and pregnancy and fetal outcome in fetuses with a normal karyotype and without structural malformations. Fetal nuchal translucency measurements were performed in 2088 chromosomally and structurally normal

  6. Increased nuchal translucency and short femur length as possible early signs of osteogenesis imperfecta type III.

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    Vimercati, Antonella; Panzarino, Mariantonietta; Totaro, Ilaria; Chincoli, Annarosa; Selvaggi, Luigi

    2013-01-01

    this paper reports an association between an increased Nuchal Translucency (NT) and Osteogenesis Imperfecta (OI), a type of skeletal dysplasia. Measurement of fetal NT at 10-14 weeks of gestation is a sensitive and effective screening method for chromosomal abnormalities. a 35-year- old Caucasian woman in her fourth pregnancy was referred to our clinic for an ultrasound scan at 12 weeks of gestation, that confirmed increased Nuchal Translucency. Chorionic villi sampling was performed, showing a normal karyotype. The patient was evaluated by a team of experienced ultra sonographers for pregnancy follow-up at our Department, that is a tertiary center. in our case the ultrasound scan at 12 week of gestation revealed only an increased NT (3 mm). Cytogenetic analysis on chorionic villi demonstrated a normal male karyotype. US follow-up, performed every 3-4 weeks, confirmed normal anthropometric parameters except for shortening of both femurs, but at 23 weeks an incorrect attitude of the feet was revealed. A clinical and radiographic diagnosis of OI type III was made only at birth, and through follow-up continuing to date. NT screening was successful for chromosomal abnormalities at 11-14 weeks of gestation. An increased NT thickness is also associated with numerous fetal anomalies and genetic syndromes in a chromosomally normal fetus. In our case there were no sonographic signs of imperfect osteogenesis in the first trimester, although there was an increased NT with a normal karyotype. currently, in literature, there are not other cases of OI type III associated with an increased NT. Our report is the first to suggest an association between an increased nuchal translucency, short femur length and osteogenesis imperfecta type III.

  7. Do Early Fetal Measurements and Nuchal Translucency Correlate With Term Birth Weight?

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    Hackmon, Rinat; Librach, Clifford; Burwick, Richard; Rodrigues, Nicole; Farine, Dan; Berger, Howard

    2017-09-01

    Traditionally, physiological variation in fetal weight is believed to emerge during the latter half of pregnancy. Although recent evidence suggests that crown-rump length (CRL) and nuchal translucency (NT) measured at 11-14 weeks correlate with abnormal fetal growth, findings have been limited by dating accuracy in spontaneous gestations. Therefore, we sought to determine whether CRL or NT measurements correlated with term birth weight (BW) or BW ratio in a cohort of IVF pregnancies, in which the date of conception is precisely known. This retrospective cohort study included 227 term, singleton IVF pregnancies. Subjects were included if they had an early first-trimester ultrasound examination and subsequent nuchal translucency (NT) screening. The difference between the measured and the expected CRL and the biparietal diameter (BPD) and NT measurement were calculated and correlated with the actual term BW or BW ratio. The BW ratio was calculated using the actual BW and the expected BW for GA. The difference between measured and expected mid-first-trimester CRL, and the BPD at NT assessment, correlated with BW ratio at delivery (r Spearman  = 0.15, P = 0.023 and r Spearman  = 0.27, P < 0.001, respectively). Absolute NT measurements and NT percentiles (adjusted for CRL) correlated with BW ratio at delivery (r Spearman  = 0.18, r = 0.14, and P = 0.005 and 0.038, respectively). In this well-dated IVF population, we report a significant correlation between BW ratio and first-trimester CRL, BPD, and NT measurements. These findings support the hypothesis that physiological variation in BW can be reflected by variation in first-trimester fetal measurements. Copyright © 2017 The Society of Obstetricians and Gynaecologists of Canada/La Société des obstétriciens et gynécologues du Canada. Published by Elsevier Inc. All rights reserved.

  8. Do the Levels of Maternal Plasma Trace Elements Affect Fetal Nuchal Translucency Thickness?

    Directory of Open Access Journals (Sweden)

    Kai-Wei Liao

    Full Text Available Fetal nuchal translucency (NT thickness is an important marker for prenatal screening; however, studies focusing on the correlation between maternal trace element levels and NT thickness are limited. The aim of this study was to evaluate maternal trace element levels during the first trimester and to investigate the association between maternal trace element levels and fetal NT thickness.In total, 113 samples were obtained from singleton pregnant women. Maternal plasma samples were collected in the first trimester of gestation. Plasma trace element levels were measured using Inductively Coupled Plasma Mass Spectrometry (ICP-MS. Nuchal translucency thickness was measured using ultrasonography at 10-14 weeks of gestation.We found that maternal plasma potassium (K levels had a significant negative correlation with both NT (r = -0.230, p < 0.05 and NT Multiples of the Median (NT MoM (r = -0.206, p < 0.05. After adjustment for potential confounders, log-transformed maternal plasma potassium levels in the first trimester were significantly associated with fetal NT (NT MoM: β = -0.68, p < 0.05; NT: β = -1.20, p < 0.01. Although not statistically significant, the As, Hg and Pb levels in maternal plasma were positively correlated with NT, and the Mg, Cu, Zn, Na and Ca levels were negatively correlated with NT.Maternal plasma K levels during the first trimester appeared to be associated with NT thickness. The essential elements tended to decrease NT thickness, and non-essential elements tended to increase it.

  9. Why increased nuchal translucency is associated with congenital heart disease: a systematic review on genetic mechanisms

    NARCIS (Netherlands)

    Burger, N.B.; Bekker, M.N.; Groot, C.J. de; Christoffels, V.M.; Haak, M.C.

    2015-01-01

    This overview provides insight into the underlying genetic mechanism of the high incidence of cardiac defects in fetuses with increased nuchal translucency (NT). Nuchal edema, the morphological equivalent of increased NT, is likely to result from abnormal lymphatic development and is strongly

  10. Submicroscopic chromosomal abnormalities in fetuses with increased nuchal translucency and normal karyotype.

    Science.gov (United States)

    Yang, Xin; Li, Ru; Fu, Fang; Zhang, Yongling; Li, Dongzhi; Liao, Can

    2017-01-01

    To investigate the submicroscopic chromosomal abnormalities in fetuses with increased nuchal translucency (NT) and normal karyotype. Total of 296 fetuses with increased NT (≥3.0 mm) were tested by conventional karyotyping. When cytogenetic analysis showed normal chromosome, the pregnancies were then consulted for array-comparative genomic hybridization (CGH) analysis and received subsequent morphology scan between 20 and 24 weeks gestation. Submicroscopic chromosomal abnormalities were assessed and compared between the fetuses with and without structural defects. Chromosomal abnormality was identified in 19.9% (59/296) fetuses. Two hundred and twenty samples were tested by array CGH. Submicroscopic chromosomal abnormalities were detected in 9.1% (20/220) fetuses. For the fetuses with abnormal morphology scan, the detection rate of submicroscopic chromosomal abnormalities was higher than those with normal morphology scan (26.9% versus 6.7%, p karyotype, especially when the structural defects were found at second or third trimester.

  11. Formative assessment based on an audit and feedback improves nuchal translucency ultrasound image quality.

    Science.gov (United States)

    Chalouhi, Gihad E; Salomon, Laurent J; Fontanges, Marianne; Althuser, Marc; Haddad, Georges; Scemama, Olivier; Chabot, Jean-Michel; Duyme, Michel; Fries, Nicolas

    2013-09-01

    The purpose of this work was to study the impact of an audit and feedback on the quality of routine first-trimester nuchal transparency ultrasound images. Eighty-eight sonographers were each sent 2 different series of 30 consecutive nuchal translucency images at a mean interval of 3 months to a dedicated, protected server for remote double-blind independent analysis based on the new Collège Français d'Echographie Foetale/Centre National de la Recherche Scientifique image-scoring method (https://www.cfef.org/evaluation/ISMCFEFCNRS.pdf). The sonographers were classified as low (score below the median) or high (score above the median) scorers for each series. Before their second evaluation, 73 of the 88 sonographers received a feedback report on their first series of images, whereas the other 15 participants received no feedback. The baseline characteristics of the participants who did and did not receive feedback were comparable. Participants who received feedback increased their average score significantly, from a mean ± SD of 11.1 ± 1.3 to 13.4 ± 1.4 among low scorers (P < .00001) and from 15.1 ± 1.2 to 16.0 ± 1.4 among high scorers (P < .001), whereas no significant change was seen among participants who received no feedback (low scorers, 10.9 ± 1.5 to 12.1 ± 2.0; P = .11; high scorers, 14.7 ± 1.3 to 14.6 ± 1.3; P = .99). The proportion of satisfactory images increased by 48% among low scorers who received feedback. Formative assessment based on a moderately intensive audit and feedback is feasible and effective for improving the quality of routine first-trimester nuchal transparency ultrasound images.

  12. [Risk assessment for fetal trisomy 21 based on nuchal translucency measurement and biochemical screening at 11-13 weeks.].

    Science.gov (United States)

    Harðardóttir, H

    2001-05-01

    Screening for fetal aneuploidy during the first trimester using fetal nuchal translucency measurement and maternal serum free ss-hCG (ss-human chorionic gonadotropin) and PAPP-A (pregnancy associated plasma protein A) is commonly practised. An approach with a one stop clinic for assessment of risk for fetal anomalies, where pre-test counseling, blood test, ultrasound and post-test counseling is offered in one hour visit is described. Based on maternal age, biochemistry and fetal nuchal translucency measurement an estimated risk for fetal trisomies 13,18 and 21 is calculated. The main benefit of this approach in screening for fetal aneuploidy is the short turnaround time, with immediate results and a low screen positive rate. This approach leads to diagnosis of the majority (95%) of fetal aneuploidy cases. If screening is positive a diagnostic test is available with chorionic villous sampling or amniocentesis. In Iceland, fetal karyotyping is offered to women 35 years and older and performed during the second trimester, but by using this approach prenatal diagnosis can be moved to the first trimester and also offered to women of all ages. A screening approach with a series of steps from 10-15 weeks, including maternal blood test at 10 and again at 15 weeks, as well as an ultrasound and nuchal translucency measurement at 11-13 weeks, with integrated results at 15+ weeks has been proposed. This method offers even lower screen positive rate (1%) while detection rates of fetal aneuploides are high (>90%) but it requires four visits instead of one and the prolonged approach is likely to cause excess anxiety for the parents to be. If all women are to be offered prenatal sreening in the first trimester the structure of prenatal care in Iceland needs some modifications including scheduling the first prenatal visit at 8-10 weeks and teaching healthcare providers counseling regarding prenatal testing.

  13. Increased nuchal translucency origins from abnormal lymphatic development and is independent of the presence of a cardiac defect

    NARCIS (Netherlands)

    Burger, Nicole B.; Bekker, Mireille N.; Kok, Evelien; de Groot, Christianne J. M.; Martin, James F.; Shou, Weinian; Scambler, Peter J.; Lee, Youngsook; Christoffels, Vincent M.; Haak, Monique C.

    2015-01-01

    To assess whether cardiac failure, because of cardiac defects, and abnormal jugular lymphatic development are involved in nuchal edema (NE) - the morphological equivalent of increased nuchal translucency - in various euploid mutant mouse models. Mouse embryos with lymphatic abnormalities and NE

  14. [Perinatal and pediatric follow up of children with increased nuchal translucency and normal karyotype].

    Science.gov (United States)

    Vieira, Lívia Adriano; Silva, Sônia Valadares Lemos; de Faria, Roberto Buenfil; Lippi, Umberto Gazi; Lopes, Reginaldo Guedes Coelho

    2013-06-01

    To analyze the perinatal and pediatric outcome of fetuses that showed nuchal translucency (NT) above the 95th percentile (P95) and a normal karyotype in order to obtain data allowing better maternal prenatal counseling. fetuses from a tertiary obstetric service with an NT above P95 and a normal karyotype were analyzed between 2005 and 2011. We analyzed gestational ultrasound follow-up, fetal and postnatal echocardiography (ECHO), weight, length and Apgar score at birth, and neuropsychomotor development by the Ages and Stages Questionnaire (ASQ) up to July 2012. During this period, there were 116 cases of nuchal translucency above the 95th percentile, and the fetal karyotype was determined in 79 of them (68%). Forty-three analyses were normal (54.4%) and 36 were altered (45.6%). Among the fetuses with a normal karyotype, one was miscarried at 15 weeks of gestation with Cantrel pentalogy and one died at 24 weeks with several structural abnormalities. There was one neonatal death of unknown cause and two cases of intraventricular communication (IVC) detected by fetal ECHO. Postnatal echocardiography revealed the persistence of IVC in one case and one case of atrial septal defect (ASD) and patent ductus arteriosus (PDA). Of the 40 surviving children, only 1 showed delayed speech development and another presented autism. The remaining cases resulted in normal neurodevelopment. During the monitoring of fetuses with increased NT and a normal karyotype, parents can be best advised that when a 2nd trimester morphological-echocardiography ultrasound study is normal, the probability of the child being born alive and well is high (93.5%).

  15. EARLY PRENATAL DIAGNOSTICS OF INBORN HEART DISEASES OF FETUSES WITH NUCHAL TRANSLUCENCY

    Directory of Open Access Journals (Sweden)

    E.A. Shevchenko

    2008-01-01

    Full Text Available The article represents an analysis of 38 events of inborn heart diseases of fetus with nuchal translucency, diagnosing on 11–16 weeks of pregnancy during consultative procedure. The spectrum of registered inborn heart diseases is represented by following nosologic forms: defect of interventricular partition, heart ectopy, atrioventricular canal, general arterial trunk, hypoplastic syndrome of the left sections of heart, fallot's tetrad, combination of defects of intracardiac partitions with diverticulum of ventricle. Frequency of registered inborn heart diseases and negative perinatal outcomes increased with the rise of thickness of nuchal translucency of fetus. transvaginal echocardiography with use of highly resolving ultra sonic equipment and new technology should be carried out in all cases of registration of widened nuchal translucency of fetus. It is decisive in improvement of diagnostics of inborn heart diseases, especially on early terms.Key words: inborn heart diseases, transvaginal echocardiography, prenatal diagnostics.

  16. Pregnancy outcome for fetuses with increased nuchal translucency but normal karyotype.

    Science.gov (United States)

    Lithner, Christina Unger; Kublickas, Marius; Ek, Sverker

    2016-03-01

    To investigate pregnancy outcome for fetuses with nuchal translucency (NT) ≥3.5 mm but normal karyotype in the Stockholm (Sweden) area. A retrospective population-based cohort study. From 2006 to 2012, fetal NT was measured in 55123 singleton pregnancies. There were 341 pregnancies with NT thickness ≥3.5 mm; 139 had a normal karyotype, 164 had an abnormal karyotype and 38 were removed from the study. Pregnancy outcome was defined as adverse (termination of pregnancy [TOP], miscarriage [MC], intrauterine fetal death [IUFD], or delivery of a child with structural defects or genetic disorders), or favourable (delivery of a child without any structural defects or genetic disorders diagnosed before discharge). Of the 139 high NT pregnancies with normal karyotype, 110 (79.2%) resulted in live births, one (0.7%) IUFD, 23 (16.5%) TOP and five (3.6%) MC. The risk of an adverse pregnancy outcome increased with increasing NT. Structural fetal defects were found in 28 (19.5%) of pregnancies undergoing second trimester ultrasound screening, of which seven resulted in live births and 21 were terminated. The most common structural defect was cardiac defects. Adverse pregnancy outcome increased with increasing NT, even with normal karyotype, however, the prognosis is good if the second trimester ultrasound screening is normal. © The Author(s) 2015.

  17. Exponentially Weighted Moving Average Chart as a Suitable Tool for Nuchal Translucency Quality Review

    Czech Academy of Sciences Publication Activity Database

    Hynek, M.; Smetanová, D.; Stejskal, D.; Zvárová, Jana

    2014-01-01

    Roč. 34, č. 4 (2014), s. 367-376 ISSN 0197-3851 Institutional support: RVO:67985807 Keywords : nuchal translucency * exponentially weighted moving average model * statistics Subject RIV: BB - Applied Statistics, Operational Research Impact factor: 3.268, year: 2014

  18. Aberrant lymphatic development in euploid fetuses with increased nuchal translucency including Noonan syndrome.

    NARCIS (Netherlands)

    Mooij, Y.M. de; Akker, N.M. van den; Bekker, M.N.; Bartelings, M.M.; Vugt, J.M.G. van; Gittenberger-de Groot, A.C.

    2011-01-01

    OBJECTIVE: Increased nuchal translucency in the human fetus is associated with aneuploidy, structural malformations and several syndromes such as Noonan syndrome. In 60-70% of the Noonan syndrome cases, a gene mutation can be demonstrated. Previous research showed that aneuploid fetuses with

  19. Early pregnancy screening for fetal aneuploidy with serum markers and nuchal translucency

    NARCIS (Netherlands)

    de Graaf, I. M.; Pajkrt, E.; Bilardo, C. M.; Leschot, N. J.; Cuckle, H. S.; van Lith, J. M.

    1999-01-01

    We determined the aneuploidy detection rate achievable by early pregnancy screening with pregnancy associated plasma protein (PAPP)-A, free beta human chorionic gonadotrophin (hCG) and ultrasound nuchal translucency (NT) measurement. Women having prenatal diagnosis were scanned, and a blood sample

  20. WAVELET ANALYSIS AND NEURAL NETWORK CLASSIFIERS TO DETECT MID-SAGITTAL SECTIONS FOR NUCHAL TRANSLUCENCY MEASUREMENT

    Directory of Open Access Journals (Sweden)

    Giuseppa Sciortino

    2016-04-01

    Full Text Available We propose a methodology to support the physician in the automatic identification of mid-sagittal sections of the fetus in ultrasound videos acquired during the first trimester of pregnancy. A good mid-sagittal section is a key requirement to make the correct measurement of nuchal translucency which is one of the main marker for screening of chromosomal defects such as trisomy 13, 18 and 21. NT measurement is beyond the scope of this article. The proposed methodology is mainly based on wavelet analysis and neural network classifiers to detect the jawbone and on radial symmetry analysis to detect the choroid plexus. Those steps allow to identify the frames which represent correct mid-sagittal sections to be processed. The performance of the proposed methodology was analyzed on 3000 random frames uniformly extracted from 10 real clinical ultrasound videos. With respect to a ground-truth provided by an expert physician, we obtained a true positive, a true negative and a balanced accuracy equal to 87.26%, 94.98% and 91.12% respectively.

  1. Transient increase in nuchal translucency thickness and reversed end-diastolic ductus venosus flow in a fetus with trisomy 18

    NARCIS (Netherlands)

    Huisman, T. W.; Bilardo, C. M.

    1997-01-01

    In a twin pregnancy discordant for trisomy 18, the affected fetus at 13 weeks' gestation had an increased nuchal translucency thickness and reversed end-diastolic ductus venosus flow. At 20 weeks' gestation there was no nuchal edema and Doppler study of the central venous vessels demonstrated normal

  2. Genomic microarray in fetuses with increased nuchal translucency and normal karyotype: a systematic review and meta-analysis.

    Science.gov (United States)

    Grande, M; Jansen, F A R; Blumenfeld, Y J; Fisher, A; Odibo, A O; Haak, M C; Borrell, A

    2015-12-01

    To estimate the incremental yield of detecting copy number variants (CNVs) by genomic microarray over karyotyping in fetuses with increased nuchal translucency (NT) diagnosed by first-trimester ultrasound. This was a systematic review conducted in accordance with PRISMA criteria. We searched PubMed, Ovid MEDLINE and Web of Science for studies published between January 2009 and January 2015 that described CNVs in fetuses with increased NT, usually defined as ≥  3.5 mm, and normal karyotype. Search terms included: fetal or prenatal, nuchal translucency or cystic hygroma or ultrasound anomaly, array comparative genomic hybridization or copy number variants, with related search terms. Risk differences were pooled to estimate the overall and stratified microarray incremental yield using RevMan. Quality assessment of included studies was performed using the Quality Assessment tool for Diagnostic Accuracy Studies (QUADAS-2) checklist. Seventeen studies met the inclusion criteria for analysis. Meta-analysis indicated an incremental yield of 5.0% (95% CI, 2.0-8.0%) for the detection of CNVs using microarray when pooling results. Stratified analysis of microarray results demonstrated a 4.0% (95% CI, 2.0-7.0%) incremental yield in cases of isolated NT and 7.0% (95% CI, 2.0-12.0%) when other malformations were present. The most common pathogenic CNVs reported were 22q11.2 deletion, 22q11.2 duplication, 10q26.12q26.3 deletion and 12q21q22 deletion. The pooled prevalence for variants of uncertain significance was 1%. The use of genomic microarray provides a 5.0% incremental yield of detecting CNVs in fetuses with increased NT and normal karyotype. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd.

  3. Screening for trisomy 21 based on maternal age, nuchal translucency measurement, first trimester biochemistry and quantitative and qualitative assessment of the flow in the DV - the assessment of efficacy.

    Science.gov (United States)

    Czuba, Bartosz; Zarotyński, Dariusz; Dubiel, Mariusz; Borowski, Dariusz; Węgrzyn, Piotr; Cnota, Wojciech; Reska-Nycz, Małgorzata; Mączka, Marek; Wielgoś, Mirosław; Sodowski, Krzysztof; Serafin, Dawid; Kubaty, Anna; Bręborowicz, Grzegorz H

    2017-01-01

    The aim of the study was to compare effects of addition of two methods of ductus venosus (DV) flow assessment: qualitative - the assessment of shape of the A-wave (positive or negative), and quantitative - based on the pulsatility index for veins (DVPI) to the basic screening for trisomy 21 at 11 to 13 + 6 weeks of pregnancy. The ultrasound examination was performed in 8230 fetuses in singleton pregnancies at 11- -13 + 6 wks, as a part of a routine screening for chromosomal defects. In DV A-wave was assessed and DVPI was calculated. After the scan blood sample was taken for first trimester biochemistry (BC). Risk for chromosomal defects was calculated and high-risk patients were offered an invasive test for karyotyping. Basic screening with following combination of markers: MA, NT and BC provided lowest detection rate (DR) 87.50% for FPR = 6.94%. After adding qualitative DV A-wave assessment DR increased to 88.75% for FPR = 5.65%. The best DR = 93.75% for FPR = 5.55% was achieved when quantitative DVPI was added. The application of the Receiver Operating Curves curve confirmed validity of the addition of DV flow assessment to the screening model. The highest diagnostic power of the test was achieved when DVPI was added, with the ROC AUC of 0.974. The assessment of DV flow performed at 11-13 + 6 weeks increases DR for trisomy 21 and reduces FPR. The screening model based on the quantitative DV flow analysis (DVPI) gives better results compared to the qualitative flow assessment.

  4. Quality of nuchal translucency measurements correlates with broader aspects of program rigor and culture of excellence.

    Science.gov (United States)

    Evans, Mark I; Krantz, David A; Hallahan, Terrence; Sherwin, John; Britt, David W

    2013-01-01

    To determine if nuchal translucency (NT) quality correlates with the extent to which clinics vary in rigor and quality control. We correlated NT performance quality (bias and precision) of 246,000 patients with two alternative measures of clinic culture - % of cases for whom nasal bone (NB) measurements were performed and % of requisitions correctly filled for race-ethnicity and weight. When requisition errors occurred in 5% (33%), the curve lowered to 0.93 MoM (p 90%, MoM was 0.99 compared to those quality exists independent of individual variation in NT quality, and two divergent indices of program rigor are associated with NT quality. Quality control must be program wide, and to effect continued improvement in the quality of NT results across time, the cultures of clinics must become a target for intervention. Copyright © 2013 S. Karger AG, Basel.

  5. Nuchal translucency distributions for different chromosomal anomalies in a large unselected population cohort

    DEFF Research Database (Denmark)

    Christiansen, Marianne; Ekelund, Charlotte K; Petersen, Olav Bjørn

    2016-01-01

    and compared with the normal/no karyotype group. RESULTS: A total of 215 223 singleton pregnancies were included in the cohort; 10548 had a normal karyotype and 1286 had an aberration. Plots of the NT measurements showed that like trisomy 21, 18 and 13 and monosomy X, the distribution for the unbalanced......OBJECTIVE: To describe the distribution of the fetal nuchal translucency thickness (NT) according to type of chromosomal aberration in a large unselected population. METHODS: Data on pregnancies with an NT measurement performed at gestational age 11 + 3 - 13 + 6 weeks from 2008 to 2011 were...... translocations was shifted towards larger NTs. The distributions for the balanced translocations, the uncommon trisomies and the triploidies more closely resembled that of the normal/no karyotype population. CONCLUSION: Fetuses with aneuploidies have NT distributions visually different from normal fetuses...

  6. Auditing ultrasound assessment of fetal nuchal translucency thickness: a review of Australian National Data 2002-2008.

    Science.gov (United States)

    Nisbet, Debbie L; Robertson, Ann C; Schluter, Philip J; McLennan, Andrew C; Hyett, Jon A

    2010-10-01

    Nuchal translucency (NT) measurement is the ultrasound component of first trimester combined screening for Down syndrome. In 2002, a NT ultrasound education and monitoring program was established in Australia. Between 2002 and 2008, a total of 728,502 NT scans were audited through this process. OVERALL AIM: To audit the availability and performance of certified operators measuring NT following implementation of the Australian education and monitoring program in 2002. Retrospective review of the central database that is used to monitor performance of individuals and practices performing NT scans in both public and private practice settings throughout Australia between 2002 and 2008. The performance of operators was assessed by a widely used international standard - that 40-60% of NT measurements should be above the median value for gestational age. The number of certified operators has increased (from 184 in 2002 to 477 in 2008). There is wide variation between states in the number of operators per birth. The percentage of certified operators with a measurement distribution meeting the international standard has increased from 40% in 2002 to 55% in 2008. Greatest improvement has been seen in operators performing 30-199 scans per year. There has been no overall improvement in performance over the last three audit cycles. The number of operators certified to perform the NT scan has increased since 2002, although availability in some states remains low. An initial improvement in performance of operators appears to have reached a plateau. It is time to become more proactive in engaging operators in the audit cycle. © 2010 The Authors. Australian and New Zealand Journal of Obstetrics and Gynaecology © 2010 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  7. Fetal cor triatriatum dexter: a report of two cases associated with nuchal edema in early second trimester

    DEFF Research Database (Denmark)

    Maroun, L.L.; Graem, N.; Skibsted, L.

    2008-01-01

    Two early-2nd-trimester fetuses were aborted as a result of nuchal edema and suspected severe heart malformation. At autopsy one fetus demonstrated nuchal edema, mild hydronephrosis, and cor triatriatum dexter associated with ventricular septal defect and tubular hypoplasia of the aortic arch...

  8. Screening for aneuploidies by maternal age, fetal nuchal translucency and maternal serum biochemistry at 11-13+6 gestational weeks

    Directory of Open Access Journals (Sweden)

    Karadžov-Orlić Nataša

    2012-01-01

    Full Text Available Introduction. Aneuploidies are the major cause of perinatal death and early psychophysical disorders. Objective. In this study, we analyzed detection and false-positive rates of screening for aneuploidies in the first trimester by the combination of maternal age, fetal nuchal translucency (NT thickness and maternal serum free beta-human chorionic gonadotrophin (β-hCG, and pregnancy-associated plasma protein-A (PAPP-A at 11-13+6 weeks of gestation, using the appropriate software developed by the Fetal Medicine Foundation. Methods. Our screening study for aneuploidies analyzed 4172 singleton pregnancies from January 2006 to December 2010. The sensitivities and false-positive rates using the combined aneuploidies determination for the risk cut-off of 1:275 were evaluated. Results. In the trisomy 21 pregnancies, the fetal NT was higher than 95th centile, in 72.8%, serum free b-hCG concentration it was above the 95th centile in 55% and serum PAPP-A was below the 5th centile in 47% of the cases. In the trisomy 18 and 13, the fetal NT was above 95th centile in 66.6% and 44.4% of the cases, respectively. The serum free b-hCG concentration was above the 95th centile in 0 and 10%, but serum PAPP-A was below 5th centile in 80.9% and 88.8% of pregnancies. In the trisomy 21 pregnancies the median free beta-hCG was 2.3 MoM and the median PAPP-A was 0.45 MoM. Chromosomal abnormalities were detected in 169 fetuses: trisomy 21 (97, Turner syndrome (19, trisomy 18 (28, trisomy 13 (11 and others (14. Detection rate of combined screening for aneuploides were 86.0% with false positive rate of 5.3% (mean age 33±4.9 years, >35 years in 35% of pregnancies. Conclusion. Our study suggests that the strategy of first-trimester combined screening of biochemical values and ultrasonographic parameters at 12 gestational weeks identifies higher percentage of aneuploidies with a lower false-positive rate than a single parameter strategy.

  9. O papel da translucência nucal no rastreamento de cardiopatias congênitas The role of nuchal translucency in the screening for congenital heart defects

    Directory of Open Access Journals (Sweden)

    Rafael Frederico Bruns

    2006-09-01

    Full Text Available OBJETIVO: Avaliar a acurácia da medida da translucência nucal (TN entre onze e treze semanas e seis dias como marcador ultra-sonográfico para rastreamento de cardiopatias congênitas (CC. MÉTODOS: Estudo multicêntrico retrospectivo, no qual foram analisadas gestações únicas de fetos euplóides. A medida da TN foi realizada no exame de primeiro trimestre quando os fetos tinham entre 45 e 84 mm de comprimento cabeça-nádega (CCN, segundo os critérios estabelecidos pela Fetal Medicine Foundation. Os casos foram seguidos até um mês após o parto para avaliar a presença de CC. RESULTADOS: Foram analisadas 3.664 gestações, das quais vinte recém-nascidos apresentaram alguma cardiopatia congênita até o primeiro mês de vida (prevalência de 0,55%. A mediana da TN nos fetos com CC foi de 1,70 mm e nos fetos sem CC foi de 1,60 mm; entretanto, não houve diferença significativa entre as duas medianas (Teste de Mann-Whitney, p>0,05. A sensibilidade da TN na detecção de CC variou de 15% a 20%, com probabilidade de falso-positivos de 86,4% a 97,9%, dependendo do ponto de corte utilizado. A razão de chance para CC foi alta, quando comparada com as indicações clássicas de ecocardiografia fetal, variando de 4,7 a 33,7, de acordo com o ponto de corte utilizado. CONCLUSÃO: Apesar da baixa sensibilidade do teste, a TN aumentada é um importante fator de risco para CC, devendo ser incluída na estratégia do seu rastreamento pré-natal.OBJECTIVE: Assess the accuracy of the nuchal translucency (NT measurement between 11 and 13 weeks and 6 days of gestation as a sonographic marker to screen for congenital heart defects (CHD. METHODS: Multicentric retrospective study, analyzing single pregnancies from euploid fetuses. NT measurement was performed in the first trimester, when fetuses had from 45 to 84 mm of crown-rump length (CRL, according to the criteria established by the Fetal Medicine Foundation. Cases were followed until 1 month after

  10. Intra-operator and inter-operator reliability of manual and semiautomated measurement of fetal nuchal translucency : a cross sectional study

    NARCIS (Netherlands)

    Bakker, M.; Mulder, P.; Birnie, E.; Bilardo, C. M.

    2013-01-01

    ObjectiveThe goal of this study was to examine the intra-operator and inter-operator differences of the manual and semiautomated nuchal translucency (NT) measurements and to evaluate if these differences alter women's risk status. MethodsA cross sectional study was performed. Two operators obtained

  11. Testing for 22q11 microdeletion in 146 fetuses with nuchal translucency above the 99th percentile and a normal karyotype

    DEFF Research Database (Denmark)

    Lautrup, Charlotte Kvist; Kjaergaard, Susanne; Brøndum-Nielsen, Karen

    2008-01-01

    The aim of this study was to examine the value of testing for a 22q11 microdeletion in fetuses with nuchal translucency (NT) above the 99th percentile (>3.5 mm). A 22q11 microdeletion results in the development of 22q11 deletion syndrome, a spectrum of disorders also known as DiGeorge/Velocardiof...

  12. Comparative studies of two dimensional and three dimensional ultrasonic nuchal translucency in trisomy assessments

    Directory of Open Access Journals (Sweden)

    Lai K. Wee

    2012-12-01

    Full Text Available Current two-dimensional (2D ultrasonic marker measurements are inherent with intra- and inter-observer variability limitations. The objective of this paper is to investigate the performance of conventional 2D ultrasonic marker measurements and proposed programmable interactive three-dimensional (3D marker evaluation. This is essentially important to analyze that the measurement on 3D volumetric measurement possesses higher impact and reproducibility vis-à-vis 2D measurement. Twenty three cases of prenatal ultrasound examination were obtained from collaborating hospital after Ethical Committee's approval. The measured 2D ultrasonic marker is Nuchal Translucency or commonly abbreviated as NT. Descriptive analysis of both 2D and 3D ultrasound measurement were calculated. Three trial measurements were taken for each method. Both data were tested with One-Sample Kolmogorov-Smirnov Test and results indicate that markers measurements were distributed normally with significant parametric values at 0.621 and 0.596 respectively. Computed mean and standard deviation for both measurement methods are 1.4495 ± 0.46490 (2D and 1.3561 ± 0.50994 (3D. ANOVA test shows that computerized 3D measurements were found to be insignificantly different from the mean of conventional 2D at the significance level of 0.05. With Pearson's correlation coefficient value or R = 0.861, the result proves strong positive linear correlation between 2D and 3D ultrasonic measurements. Reproducibility and accuracy of 3D ultrasound in NT measurement was significantly increased compared with 2D B-mode ultrasound prenatal assessment. 3D reconstructed imaging has higher clinical values compare to 2D ultrasound images with less diagnostics information.As atuais medições bidimensionais (2D com marcadores ultrassônicos com inerentes intra- e interobservadores têm limitações de variabilidade. O objetivo deste trabalho é investigar o desempenho de medições convencionais 2D com

  13. Prenatal diagnosis of Smith-Magenis syndrome in two fetuses with increased nuchal translucency, mild lateral ventriculomegaly, and congenital heart defects.

    Science.gov (United States)

    Lei, Ting-Ying; Li, Ru; Fu, Fang; Wan, Jun-Hui; Zhang, Yong-Ling; Jing, Xiang-Yi; Liao, Can

    2016-12-01

    Smith-Magenis syndrome (SMS) is a multiple congenital anomalies/mental retardation disorder characterized by an interstitial deletion involving chromosome 17p11.2 containing the retinoic acid-induced 1 (RAI1) gene or due to mutation of RAI1. Few cases have been reported in the medical literature regarding prenatal diagnosis of SMS. We report on the prenatal diagnosis of SMS in two fetuses with increased nuchal translucency (NT), mild lateral ventriculomegaly, and congenital heart defects by whole-genome and high-resolution chromosome microarray analysis (CMA). The CMA result of Fetus 1, which had increased NT, mild lateral ventriculomegaly, tricuspid regurgitation, and right aortic arch with left ductus arteriosus, revealed a de novo 4.79-Mb deletion at 17p12p11.2. Fetus 2 had increased NT, pulmonary stenosis, and a ventricular septal defect, and showed a de novo 3.68-Mb deletion at 17p11.2. The findings further confirm that increased NT is associated with genetic syndromes, and brain imaging is necessary for SMS fetuses. Both deletions encompass the SMS "critical region", which includes many genes including RAI1. However, the precise gene(s) responsible for the heart defects in SMS remain unclear; further efforts should be undertaken to understand the molecular basis of this syndrome. Copyright © 2016. Published by Elsevier B.V.

  14. First-trimester combined screening for Down syndrome

    DEFF Research Database (Denmark)

    Pihl, Kasper; Sørensen, Tina Lindvig; Nørgaard Pedersen, Bent

    2008-01-01

    OBJECTIVE: To establish the relationship between the first-trimester screening markers [pregnancy-associated plasma protein A (PAPP-A), free human chorionic gonadotrophin-beta (beta-hCG), nuchal translucency (NT)], the Down syndrome (DS) risk estimate, and the adverse outcomes such as low birth...

  15. Adverse Pregnancy Outcomes after Abnormal First Trimester Screening for Aneuploidy

    OpenAIRE

    Goetzl, Laura

    2010-01-01

    Women with abnormal first trimester screening but with a normal karyotype are at risk for adverse pregnancy outcomes. A nuchal translucency >3.5mm is associated with an increased risk of subsequent pregnancy loss, fetal infection, fetal heart abnormalities and other structural abnormalities. Abnormal first trimester analytes are also associated with adverse pregnancy outcomes but the predictive value is less impressive. As a single marker, PAPP-A

  16. Curva de referência para a medida da translucência nucal na população capixaba Reference range curve of nuchal translucency in the population of the State of Espírito Santo, Brazil

    Directory of Open Access Journals (Sweden)

    Luiz Cláudio França

    2004-12-01

    Full Text Available OBJETIVO: Estudar o comportamento da medida da translucência nucal (TN na população capixaba, no período entre a 10ª e a 14ª semanas de gestação. MATERIAIS E MÉTODOS: Estudou-se de forma transversal 853 fetos, consecutivamente, que apresentaram cariótipos ou fenótipos normais. Todos os fetos foram submetidos, durante a ultra-sonografia de rotina, à medida da TN. A análise estatística utilizou o teste "t" de Student e ANOVA. O teste de regressão ajustou o melhor modelo matemático para traduzir o comportamento da TN. RESULTADOS: A idade materna variou de 14 a 49 anos (média de 30,2 anos, sendo que 22,1% encontravam-se com mais de 35 anos. A TN mostrou comportamento crescente com a idade gestacional e o comprimento cabeça-nádegas (CCN. Houve 73 casos (6,46% de fetos normais com TN maior que 2,5 mm. O melhor modelo matemático encontrado para representar o comportamento da TN foi a regressão linear simples (TN = 0,414 + 0,020 × CCN, que permitiu estabelecer curva de normalidade com os percentis 5, 10, 25, 50, 75, 90 e 95. CONCLUSÃO: A TN apresenta comportamento crescente com o avançar da idade gestacional, no período de 10 a 14 semanas. A população capixaba apresenta medidas de TN semelhantes às demais populações já testadas.OBJECTIVE: To assess the behavior of nuchal translucency (NT in the population of the State of Espírito Santo, Brazil, during weeks 10 to 14 of pregnancy and to establish a reference range for this population. MATERIALS AND METHODS: A transversal study was performed in 853 fetuses which presented normal cariotype or phenotype. All the fetuses were submitted to ultrasound analysis for NT measurement, during routine ultrasound examinations. The Student's "t" test and ANOVA were used in the statistical analysis. The regression test was used to adjust the better mathematical model to translate the NT behavior. RESULTS: Maternal age varied between 14 to 49 years (mean 30.2%, and 22.1% were above 35

  17. Translucência nucal aumentada e cariótipo normal: evolução pré e pós-natal Increased fetal nuchal translucency thickness and normal karyotype: prenatal and postnatal follow-up

    Directory of Open Access Journals (Sweden)

    Fátima Aparecida Targino Saldanha

    2009-01-01

    Full Text Available OBJETIVO: O objetivo do presente estudo foi avaliar a evolução pré e pós-natal dos fetos com translucência nucal (TN aumentada e cariótipo normal. MÉTODOS: Duzentos e setenta e cinco fetos com TN aumentada foram avaliados no setor de Medicina Fetal da Clínica Obstétrica do HC-FMUSP. Esses casos foram submetidos à avaliação do cariótipo, ultrassonografia seriada, ecocardiografias fetal e pós-natal e avaliação clínica genética pós-natal. RESULTADOS: Em 14,2% dos casos, o cariótipo esteve alterado e em 85,8% o cariótipo ou fenótipo foi normal. Nos casos com cariótipo normal, a ultrassonografia morfológica de segundo trimestre esteve alterada em 24,7%, destes, um terço apresentou malformações estruturais maiores, sendo 35,7% cardíacas. Resultados gestacionais adversos, como abortamento, óbitos intraútero e neonatal ocorreram em 10,2% dos casos. A avaliação pós-natal foi realizada em 72,7% das crianças, mostrando-se alterada em 14,8%. A frequência de criança viva e saudável diminuiu com o aumento da medida da TN, sendo de 37,5% quando a TN foi igual ou maior que 4,5 mm. CONCLUSÃO: Nos fetos com TN aumentada e cariótipo normal, quanto maior a medida da TN maior a frequência de malformações estruturais, em especial defeitos cardíacos, resultados gestacionais adversos e alterações na avaliação pós-natal.OBJECTIVE: The aim of this study was to evaluate pregnancy and postnatal outcomes of fetuses with increased nuchal translucency thickness (NT and normal karyotype. METHODS: Two hundred seventy five fetuses with increased NT were examined with karyotyping analysis, serial ultrasound scans, echocardiography and postnatal clinical and genetic evaluation at the Fetal Medicine Unit - Department of Obstetrics - São Paulo University. RESULTS: The karyotype was abnormal in 14.2% of the cases and normal in 85.8%. In cases with normal karyotype 24.7% presented structural abnormalities at the anomaly scan, one third

  18. Praenatal diagnostik i Arhus og Viborg Amter efter implementering af første trimester-risikovurdering

    DEFF Research Database (Denmark)

    Tørring, Niels; Jølving, Line Riis; Petersen, Olav Bennike Bjørn

    2008-01-01

    In 2004 the Danish National Board of Health issued new guidelines for prenatal diagnostics in Denmark. The guidelines include a general offer to all pregnant women in Denmark of first trimester risk assessment of combined non-invasive tests integrating measurement of nuchal translucency...

  19. Biological variation of free β chorionic gonadotropin and pregnancy-associated plasma protein A in first trimester pregnancies

    DEFF Research Database (Denmark)

    Sennels, Henriette P; Jørgensen, Finn Stener; Sørensen, Steen

    2011-01-01

    Abstract Background: Trisomy 21 risk estimation in first trimester pregnancies can be performed by a combined test based on ultrasound measurement of fetal nuchal translucency thickness and maternal plasma concentrations of free ß human chorionic gonadotropin (hCGß) and pregnancy-associated plasma...

  20. Biological variation of free β chorionic gonadotropin and pregnancy-associated plasma protein A in first trimester pregnancies

    DEFF Research Database (Denmark)

    Sennels, Henriette P; Jørgensen, Finn Stener; Sørensen, Steen

    2011-01-01

    Abstract Background: Trisomy 21 risk estimation in first trimester pregnancies can be performed by a combined test based on ultrasound measurement of fetal nuchal translucency thickness and maternal plasma concentrations of free β human chorionic gonadotropin (hCGβ) and pregnancy-associated plasma...

  1. A comparison of the impact of screen-positive results obtained from ultrasound and biochemical screening for Down syndrome in the first trimester : a pilot study

    NARCIS (Netherlands)

    Weinans, M.J.; Kooij, L.; Muller, M.A.; Bilardo, K.M.; van Lith, J.M.; Tymstra, T.

    2004-01-01

    OBJECTIVE: To compare the experiences of women who received a screen-positive test result for Down syndrome after nuchal translucency screening or after biochemical screening in the first trimester of pregnancy in the Netherlands. METHOD: Semi-quantitative questionnaires were sent to 40 women with a

  2. A comparison of the impact of screen-positive results obtained from ultrasound and biochemical screening for Down syndrome in the first trimester: a pilot study

    NARCIS (Netherlands)

    Weinans, Martin J. N.; Kooij, Loes; Müller, Moira A.; Bilardo, Katia M.; van Lith, Jan M. M.; Tymstra, Tjeerd

    2004-01-01

    Objective To compare the experiences of women who received a screen-positive test result for Down syndrome after nuchal translucency screening or after biochemical screening in the first trimester of pregnancy in the Netherlands. Method Semi-quantitative questionnaires were sent to 40 women with a

  3. Prospective study evaluating performance of first-trimester combined screening for trisomy 21 using repeat sampling of maternal serum markers PAPP-A and free β-hCG

    DEFF Research Database (Denmark)

    Ekelund, C; Wright, D; Ball, S

    2012-01-01

    To prospectively evaluate the performance of first-trimester combined screening for trisomy 21 using the biochemical markers pregnancy-associated plasma protein-A (PAPP-A) and free beta-human chorionic gonadotropin (free β-hCG) obtained before and at the time of the nuchal translucency (NT) scan....

  4. Adverse Pregnancy Outcomes after Abnormal First Trimester Screening for Aneuploidy

    Science.gov (United States)

    Goetzl, Laura

    2010-01-01

    Women with abnormal first trimester screening but with a normal karyotype are at risk for adverse pregnancy outcomes. A nuchal translucency >3.5mm is associated with an increased risk of subsequent pregnancy loss, fetal infection, fetal heart abnormalities and other structural abnormalities. Abnormal first trimester analytes are also associated with adverse pregnancy outcomes but the predictive value is less impressive. As a single marker, PAPP-A screening with the possible addition of uterine artery PI assessment in the midtrimester. PMID:20638576

  5. Praenatal diagnostik i Arhus og Viborg Amter efter implementering af første trimester-risikovurdering

    DEFF Research Database (Denmark)

    Tørring, Niels; Jølving, Line Riis; Petersen, Olav Bennike Bjørn

    2008-01-01

    In 2004 the Danish National Board of Health issued new guidelines for prenatal diagnostics in Denmark. The guidelines include a general offer to all pregnant women in Denmark of first trimester risk assessment of combined non-invasive tests integrating measurement of nuchal translucency...... and maternal biochemistry for detection of fetal chromosomal abnormalities like trisomy 21, and replacing the screening criteria of > or =35 of age....

  6. First-trimester screening markers are altered in pregnancies conceived after IVF/ICSI

    DEFF Research Database (Denmark)

    Gjerris, A C; Loft, A; Pinborg, A

    2009-01-01

    or not to correct risk calculation for mode of conception. METHODS: A national prospective cohort study of 1000 pregnancies achieved after ART was compared with a control group of 2543 pregnancies conceived spontaneously. All women completed a first-trimester combined screening program. Risk calculation...... between groups. The median nuchal translucency thickness was smaller in the overall ART group compared with controls. The false-positive rate of first-trimester combined screening in the overall ART group, adjusted for maternal age, was significantly higher when compared with controls (9.0% vs. 6...

  7. Cardiac defects, nuchal edema and abnormal lymphatic development are not associated with morphological changes in the ductus venosus

    NARCIS (Netherlands)

    Burger, Nicole B.; Haak, Monique C.; Kok, Evelien; de Groot, Christianne J. M.; Shou, Weinian; Scambler, Peter J.; Lee, Youngsook; Cho, Eunjin; Christoffels, Vincent M.; Bekker, Mireille N.

    2016-01-01

    In human fetuses with cardiac defects and increased nuchal translucency, abnormal ductus venosus flow velocity waveforms are observed. It is unknown whether abnormal ductus venosus flow velocity waveforms in fetuses with increased nuchal translucency are a reflection of altered cardiac function or

  8. Cardiac defects, nuchal edema and abnormal lymphatic development are not associated with morphological changes in the ductus venosus

    NARCIS (Netherlands)

    Burger, Nicole B.; Haak, Monique C.; Kok, Evelien; de Groot, Christianne J M; Shou, Weinian; Scambler, Peter J.; Lee, Youngsook; Cho, Eunjin; Christoffels, Vincent M.; Bekker, Mireille N.

    2016-01-01

    Background In human fetuses with cardiac defects and increased nuchal translucency, abnormal ductus venosus flow velocity waveforms are observed. It is unknown whether abnormal ductus venosus flow velocity waveforms in fetuses with increased nuchal translucency are a reflection of altered cardiac

  9. First Trimester Down Syndrome Screen

    Science.gov (United States)

    ... Syndrome Staph Infections and MRSA Stroke Testicular Cancer Thalassemia Thyroid ... protein-A (PAPP-A) with hCG, total or free beta subunit and nuchal translucency ultrasound Formal Name First ...

  10. Gender impact on first trimester markers in Down syndrome screening

    DEFF Research Database (Denmark)

    Larsen, Severin Olesen; Wøjdemann, Karen R; Shalmi, Anne-Cathrine

    2002-01-01

    with normal outcome. Mean log MoM values for pregnancies with female and male fetuses were calculated using regression of log marker values on gestational age expressed as crown rump length and on maternal weight. A pronounced gender impact was found for free betahCG, being 16% higher for female than for male......The influence of fetal gender on the level in the first trimester of the serological markers alpha-fetoprotein (AFP), pregnancy-associated plasma protein-A (PAPP-A) and free beta human chorionic gonadotropin (betahCG) and on nuchal translucency is described for 2637 singleton pregnancies...

  11. A historical and practical review of first trimester aneuploidy screening.

    Science.gov (United States)

    Russo, Melissa L; Blakemore, Karin J

    2014-06-01

    There have been tremendous advancements over the past three decades in prenatal screening for aneuploidy and we have changed our practice from screening by maternal age alone to 'combined' first trimester screening and circulating cell-free fetal DNA. We currently use the nuchal translucency and biochemical markers of free β-hCG and PAPP-A to determine the risk of fetal aneuploidy. The primary goal is to identify higher risk women for fetal aneuploidy early in pregnancy and give them the option to pursue invasive testing in a timely manner if desired. Copyright © 2013 Elsevier Ltd. All rights reserved.

  12. Combined first- and second-trimester screening for Down syndrome

    DEFF Research Database (Denmark)

    Rode, Line; Wøjdemann, Karen R; Shalmi, Anne-Cathrine

    2003-01-01

    and their correlations, derived from our normal material and Down syndrome cases from the literature. RESULTS: Using a fixed screen-positive rate (SPR) of 5%, the first-trimester combined test [nuchal translucency (NT), PAPP-A and free beta-hCG] yielded a detection rate (DR) of 76%, and the integrated test (NT, PAPP......%. CONCLUSION: These results suggest that proMBP may be an important new marker in Down syndrome screening and, in particular, a good substitute for inhibin A....

  13. First-trimester screening for trisomy 21 in Denmark

    DEFF Research Database (Denmark)

    Ekelund, C K; Petersen, O B; Skibsted, L

    2011-01-01

    strategy for T21 has changed the gestational age at which trisomy 18 (T18) and trisomy 13 (T13) are diagnosed prenatally, and the number of infants born with T18 or T13. METHODS: We collected from the Danish Cytogenetic Central Register information on all prenatal and postnatal chromosome analyses for T18......OBJECTIVES: In Denmark a new national guideline for prenatal screening and diagnosis was issued in 2004 according to which all pregnant women should be offered a first-trimester combined risk assessment for trisomy 21 (T21). The aim of this study was to investigate whether the new screening...... or T13, registered from 1997 to 2007. Information on first-trimester screening results was collected from each department of obstetrics and gynecology performing the nuchal translucency scans. The cut-off used for referral to invasive diagnostic testing for T21 and for T18/T13 was 1 : 300 and 1 : 150...

  14. Interstitial pregnancy undetected during earlier first-trimester screening for fetal aneuploidy at 13 weeks' gestation.

    Science.gov (United States)

    Sherer, David M; Dalloul, Mudar; Sokolovski, Margarita; Borawski, Dorota; Granderson, Freda; Abulafia, Ovadia

    2009-01-01

    First-trimester screening for fetal aneuploidy using nuchal translucency (NT), pregnancy-associated plasma protein A, free or total beta-hCG, and maternal age constitutes a very effective screening test for fetal Down syndrome. We describe a case in which a patient presented at 14 weeks' gestation with an acute abdomen 1 week after first-trimester screening (including NT measurement) performed elsewhere, which was negative for trisomies 21 and 18. Sonographic examination revealed an interstitial pregnancy with a singleton fetus with present cardiac activity, which had not been noted 1 week earlier at the time of earlier transabdominal NT measurement. This case indicates that successful acquisition of a NT measurement during first-trimester screening for fetal aneuploidy does not negate the rare possibility of an unusual ectopic pregnancy. 2008 Wiley Periodicals, Inc.

  15. Biological variation of free β chorionic gonadotropin and pregnancy-associated plasma protein A in first trimester pregnancies

    DEFF Research Database (Denmark)

    Sennels, Henriette P; Jørgensen, Finn Stener; Sørensen, Steen

    2011-01-01

    Abstract Background: Trisomy 21 risk estimation in first trimester pregnancies can be performed by a combined test based on ultrasound measurement of fetal nuchal translucency thickness and maternal plasma concentrations of free ß human chorionic gonadotropin (hCGß) and pregnancy-associated plasma.......9%-48.5% for hCGß and 31.6%-63.3% for PAPP-A, increasing with time between sampling. The average overall biological variation for hCGß was 29%, and 49.7% for PAPP-A. Conclusions: We found high biological variation for plasma concentrations of hCGß and PAPP-A, increasing with longer time intervals between...

  16. Do we need readjustment of the biochemical parameters in first trimester combined aneuploidy screening test in women with polycystic ovary syndrome?

    Science.gov (United States)

    Karsli, Mehmet Fatih; Gultekin, Ismail Burak; Cakmak, Bulent; Yeral, Mahmut Ilkin; Seckin, Kerem Doga; Alt Nboga, Orhan; Kucukozkan, Tuncay

    2014-11-01

    The aim of this study was to determine whether polycystic ovary syndrome (PCOS) affects the biochemical components of first trimester combined aneuploidy screening test. A case-control study was performed at a tertiary referral hospital between years 2007-2013. Singleton pregnancies in the first trimester (11(+0) -13(+6) week) who had a history of PCOS and underwent first trimester combined aneuploidy screening test were included in the study. Three hundred and seventeen women met the criteria for inclusion. Control group was formed by 942 healthy pregnant women with similar gestational and maternal ages using a 1 : 3 ratio. Pregnancy-associated plasma protein-A (PAPP-A), free β-human chorionic gonadotropin (fβ-hCG) and fetal nuchal translucency were compared between the study group and the controls. The biochemical components PAPP-A and fβ-hCG were significantly lower in the PCOS group compared with the control group (p = 0.001). There was no difference among groups with regard to the nuchal translucency measurements (p = 0.128). Our study shows that the levels of biochemical components of first trimester combined aneuploidy screening test (PAPP-A and fβ-hCG) are altered in pregnant women with PCOS. Future trials of larger scale are needed to asses any need for readjustment of the risk in the patient population with PCOS. © 2014 John Wiley & Sons, Ltd.

  17. Translucent Insulation

    DEFF Research Database (Denmark)

    Rahbek, Jens Eg

    1998-01-01

    Two new types of translucent materials are presented. One is translucent fiber insulation and the other type is a new type of hony-comb made of Celulose-acetat. Data for the materials and calculations of energy savings when using the materials in building envelopes are presented....

  18. First-trimester risk calculation for trisomy 13, 18, and 21: comparison of the screening efficiency between 2 locally developed programs and commercial software

    DEFF Research Database (Denmark)

    Sørensen, Steen; Momsen, Günther; Sundberg, Karin

    2011-01-01

    -A) in maternal plasma from unaffected pregnancies. Means and SDs of these parameters in unaffected and affected pregnancies are used in the risk calculation program. Unfortunately, our commercial program for risk calculation (Astraia) did not allow use of local medians. We developed 2 alternative risk......Reliable individual risk calculation for trisomy (T) 13, 18, and 21 in first-trimester screening depends on good estimates of the medians for fetal nuchal translucency thickness (NT), free ß-subunit of human chorionic gonadotropin (hCGß), and pregnancy-associated plasma protein-A (PAPP...

  19. Adverse pregnancy outcomes after abnormal first-trimester screening for aneuploidy.

    Science.gov (United States)

    Goetzl, Laura

    2010-09-01

    Women with abnormal results of first trimester screening but with a normal karyotype are at risk for adverse pregnancy outcomes. A nuchal translucency of greater than 3.5 mm is associated with an increased risk of subsequent pregnancy loss, fetal infection, fetal heart abnormalities, and other structural abnormalities. Abnormal levels of first trimester analytes are also associated with adverse pregnancy outcomes, but the predictive value is less impressive. As a single marker, pregnancy-associated plasma protein (PAPP)-A level less than 1st percentile has a good predictive value for subsequent fetal growth restriction. Women with PAPP-A level less than 5th percentile should undergo subsequent risk assessment with routine maternal serum afetoprotein screening with the possible addition of uterine artery pulsatility index assessment in the midtrimester. Copyright 2010 Elsevier Inc. All rights reserved.

  20. First-trimester risk calculation for trisomy 13, 18, and 21: comparison of the screening efficiency between 2 locally developed programs and commercial software

    DEFF Research Database (Denmark)

    Sørensen, Steen; Momsen, Günther; Sundberg, Karin

    2011-01-01

    Reliable individual risk calculation for trisomy (T) 13, 18, and 21 in first-trimester screening depends on good estimates of the medians for fetal nuchal translucency thickness (NT), free β-subunit of human chorionic gonadotropin (hCGβ), and pregnancy-associated plasma protein-A (PAPP-A) in mate......Reliable individual risk calculation for trisomy (T) 13, 18, and 21 in first-trimester screening depends on good estimates of the medians for fetal nuchal translucency thickness (NT), free β-subunit of human chorionic gonadotropin (hCGβ), and pregnancy-associated plasma protein-A (PAPP......-A) in maternal plasma from unaffected pregnancies. Means and SDs of these parameters in unaffected and affected pregnancies are used in the risk calculation program. Unfortunately, our commercial program for risk calculation (Astraia) did not allow use of local medians. We developed 2 alternative risk...... calculation programs to assess whether the screening efficacies for T13, T18, and T21 could be improved by using our locally estimated medians....

  1. First-trimester risk calculation for trisomy 13, 18, and 21: comparison of the screening efficiency between 2 locally developed programs and commercial software

    DEFF Research Database (Denmark)

    Sørensen, Steen; Momsen, Günther; Sundberg, Karin

    2011-01-01

    Reliable individual risk calculation for trisomy (T) 13, 18, and 21 in first-trimester screening depends on good estimates of the medians for fetal nuchal translucency thickness (NT), free ß-subunit of human chorionic gonadotropin (hCGß), and pregnancy-associated plasma protein-A (PAPP-A) in mate......Reliable individual risk calculation for trisomy (T) 13, 18, and 21 in first-trimester screening depends on good estimates of the medians for fetal nuchal translucency thickness (NT), free ß-subunit of human chorionic gonadotropin (hCGß), and pregnancy-associated plasma protein-A (PAPP......-A) in maternal plasma from unaffected pregnancies. Means and SDs of these parameters in unaffected and affected pregnancies are used in the risk calculation program. Unfortunately, our commercial program for risk calculation (Astraia) did not allow use of local medians. We developed 2 alternative risk...... calculation programs to assess whether the screening efficacies for T13, T18, and T21 could be improved by using our locally estimated medians....

  2. Intracranial translucency as a sonographic marker for detecting open spina bifida at 11-13+6weeks scan: Our experience.

    Science.gov (United States)

    Teegala, Madhavi L; Vinayak, Dhamangaonkar G

    2017-01-01

    The fourth ventricle, seen as intracranial translucency (IT) at 11-13 +6 weeks, has been reported to be obliterated in cases of open spina bifida (OSB). Our aim was to assess its role in detecting OSB at 11-13 +6 weeks. This prospective study was conducted at foetal medicine unit from January 2014 to June 2015. All women who underwent both first and mid-trimester scan in our unit were included in the study. IT was categorized as normal, obliterated or not clear. Spine was examined during both scans. Totally, 341 cases were included in the study. IT was found to be obliterated in four cases and not clear in one case. There was demonstrable OSB at 11-13 +6 weeks in two cases, at 15-16 weeks in two cases and at 24 weeks in one case. In the remaining 336 cases with normal IT, spine was found to be normal at target scan. Mid-sagittal view of face that is routinely used to measure nuchal translucency (NT) can also be used to detect OSB. It is feasible to integrate IT into the routine 11-13 +6 weeks scan.

  3. Comparison of measured concentration values of biochemical serum markers with two immunoassay systems in first trimester screening for fetal aneuploidy.

    Science.gov (United States)

    Hörmansdörfer, Cindy; Soergel, Philipp; Hillemanns, Peter; Schmidt, Peter

    2012-02-01

    Non-invasive first trimester screening for fetal aneuploidy is based on the consideration of fetal nuchal translucency, biochemical serum markers 'pregnancy associated plasma protein A' (PAPP-A), and 'free beta-humane chorionic gonadotropin' (fβ-hCG). The blood sera of 168 pregnant women in 11 + 0 to 13 + 6 weeks of gestation were examined by both the COBAS (Roche Holding GmbH, Germany) and KRYPTOR (Brahms GmbH, Germany) immunoassay systems in two quality controlled laboratories. The concentration values were converted into multiple of median (MoM) values and compared through a two-tailed t test. The concentration values of PAPP-A differed significantly from each other (p pregnancy outcomes.

  4. First trimester screening for Down syndrome and assisted reproduction: no basis for concern

    DEFF Research Database (Denmark)

    Wøjdemann, K R; Larsen, S O; Shalmi, A

    2001-01-01

    In pregnancies obtained after assisted reproduction the false-positive rate of second trimester Down syndrome (DS) screening is increased by 1.5-3-fold. This may cause an increase in the number of amniocenteses and the fetal loss rate. The present study for the first time examined whether assisted.......93-1.25) for beta-hCG and 1.02 (95% CI: 0.95-1.11) for NT. The first trimester marker values in assisted reproductive pregnancies and spontaneously conceived pregnancies were not significantly different. Estimated false-positive rates for a risk cut-off of 1:400 varied from 4.7% in IVF pregnancies to 5.1% in OI...... reproductive technologies affect the results of first trimester screening. The markers PAPP-A, free beta-hCG and the nuchal translucency (NT) thickness were examined at 12-14 weeks' gestation. Screening markers in 47 in vitro fertilisation (IVF), 63 ovulation induction (OI) and 3026 spontaneously conceived...

  5. First-trimester combined screening for trisomy 21 in women at risk for α-thalassemia.

    Science.gov (United States)

    Zhen, Li; Pan, Min; Han, Jin; Yang, Xin; Liao, Can; Li, Dong-Zhi

    2016-01-01

    To report the strategy of first-trimester aneuploidy screening in pregnancies at risk for homozygous α(0)-thalassemian. Women at risk of homozygous α(0)-thalassemia were given an ultrasound examination at 11-14 weeks' gestation to exclude an affected pregnancy. Fetal cardiothoracic ratio (CTR) and nuchal translucence (NT) were measured. If cardiomegaly was found, chorionic villus sampling (CVS) was offered for α-thalassemia; otherwise the first-trimester combined screening test was performed on the pregnancy. The invasive testing for karyotyping was only followed in those cases with a positive aneuploidy screening test. In total, 69 of 288 pregnancies were found to be affected by homozygous α(0)-thalassemia using ultrasound, and the findings were confirmed by invasive testing. In the remaining 219 pregnancies, invasive testing was not performed for α-thalassemia because of a normal fetal CTR, and the women received the first-trimester combined screening. Nine CVS procedures were performed for karyotyping because of a positive aneuploidy screening. Totally three pregnancies with aneuploidy were diagnosed and terminated. Our strategy can selectively detect aneuploidy pregnancies not affected by homozygous α-thalassemia, and, meanwhile, save on the cost of unnecessary aneuploidy screening or karyotyping in pregnancies with an affected fetus of homozygous α(0)-thalassemia.

  6. The impact of inherited thrombophilia on first trimester combined aneuploidy screening test parameters.

    Science.gov (United States)

    Karsli, Mehmet Fatih; Baser, Eralp; Seckin, Kerem Doga; Yeral, Mahmut İlkin; Togrul, Cihan; Ugur, Mustafa

    2014-03-01

    To determine whether inherited thrombophilia affects components of first trimester combined aneuploidy screening test. A case-control study was performed between January 1st and December 31st 2011, at a tertiary referral hospital. Singleton pregnancies with inherited thrombophilia that underwent first trimester (11-13(+6) week) combined aneuploidy screening test were included in the study. Pregnancy associated plasma protein-A (PAPP-A), free beta-human chorionic gonadotropin (fbHCG) and fetal nuchal translucency (NT) were compared between the study group and controls. Within the study period, 15,881 women with singleton pregnancies had a combined first trimester aneuploidy screening test at our institution. Among these, 207 women met the inclusion criteria. A control group that comprised 625 women with similar gestational age was generated, using a 1:3 ratio. PAPP-A levels were significantly higher, whereas fbHCG levels and fetal NT measurements were lower in women with inherited thrombophilia (p < 0.001). Our study suggested that PAPP-A, free b-HCG and NT MoM levels display alterations in women with inherited thrombophilia. Future trials are needed to assess the need for readjustment of risk in these patients.

  7. First Trimester Aneuploidy Screening Program for Preeclampsia Prediction in a Portuguese Obstetric Population

    Directory of Open Access Journals (Sweden)

    Cláudia Teixeira

    2014-01-01

    Full Text Available Objective. To evaluate the performance of a first trimester aneuploidy screening program for preeclampsia (PE prediction in a Portuguese obstetric population, when performed under routine clinical conditions. Materials and Methods. Retrospective cohort study of 5672 pregnant women who underwent routine first trimester aneuploidy screening in a Portuguese university hospital from January 2009 to June 2013. Logistic regression-based predictive models were developed for prediction of PE based on maternal characteristics, crown-rump length (CRL, nuchal translucency thickness (NT, and maternal serum levels of pregnancy-associated plasma protein-A (PAPP-A and free beta-subunit of human chorionic gonadotropin (free β-hCG. Results. At a false-positive rate of 5/10%, the detection rate for early-onset (EO-PE and late-onset (LO-PE PE was 31.4/45.7% and 29.5/35.2%, respectively. Although both forms of PE were associated with decreased PAPP-A, logistic regression analysis revealed significant contributions from maternal factors, free β-hCG, CRL, and NT, but not PAPP-A, for prediction of PE. Conclusion. Our findings support that both clinical forms of EO-PE and LO-PE can be predicted using a combination of maternal history and biomarkers assessed at first trimester aneuploidy screening. However, detection rates were modest, suggesting that models need to be improved with additional markers not included in the current aneuploidy screening programs.

  8. Intracranial translucency as a sonographic marker for detecting open spina bifida at 11–13+6 weeks scan: Our experience

    Science.gov (United States)

    Teegala, Madhavi L; Vinayak, Dhamangaonkar G

    2017-01-01

    Aims and Objectives: The fourth ventricle, seen as intracranial translucency (IT) at 11–13+6 weeks, has been reported to be obliterated in cases of open spina bifida (OSB). Our aim was to assess its role in detecting OSB at 11–13+6 weeks. Materials and Methods: This prospective study was conducted at foetal medicine unit from January 2014 to June 2015. All women who underwent both first and mid-trimester scan in our unit were included in the study. IT was categorized as normal, obliterated or not clear. Spine was examined during both scans. Results: Totally, 341 cases were included in the study. IT was found to be obliterated in four cases and not clear in one case. There was demonstrable OSB at 11–13+6 weeks in two cases, at 15–16 weeks in two cases and at 24 weeks in one case. In the remaining 336 cases with normal IT, spine was found to be normal at target scan. Conclusion: Mid-sagittal view of face that is routinely used to measure nuchal translucency (NT) can also be used to detect OSB. It is feasible to integrate IT into the routine 11–13+6 weeks scan. PMID:29379237

  9. Intracranial translucency as a sonographic marker for detecting open spina bifida at 11–13+6 weeks scan: Our experience

    Directory of Open Access Journals (Sweden)

    Madhavi L Teegala

    2017-01-01

    Full Text Available Aims and Objectives: The fourth ventricle, seen as intracranial translucency (IT at 11–13+6 weeks, has been reported to be obliterated in cases of open spina bifida (OSB. Our aim was to assess its role in detecting OSB at 11–13+6 weeks. Materials and Methods: This prospective study was conducted at foetal medicine unit from January 2014 to June 2015. All women who underwent both first and mid-trimester scan in our unit were included in the study. IT was categorized as normal, obliterated or not clear. Spine was examined during both scans. Results: Totally, 341 cases were included in the study. IT was found to be obliterated in four cases and not clear in one case. There was demonstrable OSB at 11–13+6 weeks in two cases, at 15–16 weeks in two cases and at 24 weeks in one case. In the remaining 336 cases with normal IT, spine was found to be normal at target scan. Conclusion: Mid-sagittal view of face that is routinely used to measure nuchal translucency (NT can also be used to detect OSB. It is feasible to integrate IT into the routine 11–13+6 weeks scan.

  10. Advances in prenatal screening for Down syndrome: II first trimester testing, integrated testing, and future directions.

    Science.gov (United States)

    Benn, Peter A

    2002-10-01

    The acceptability of prenatal screening and diagnosis of Down syndrome is dependent, in part, on the gestational age at which the testing is offered. First trimester screening could be advantageous if it has sufficient efficacy and can be effectively delivered. Two first trimester maternal serum screening markers, pregnancy-associated plasma protein-A (PAPP-A) and free beta-human chorionic gonadotropin (beta-hCG), are useful for identifying women at increased risk for fetal Down syndrome. In addition, measurement of an enlarged thickness of the subcutaneous fluid-filled space at the back of the neck of the developing fetus (referred to as nuchal translucency or NT) has been demonstrated to be an indicator for these high-risk pregnancies. When these three parameters are combined, estimates for Down syndrome efficacy exceed those currently attainable in the second trimester. Women who are screen-positive in the first trimester can elect to receive cytogenetic testing of a chorionic villus biopsy. The first trimester tests could also, theoretically, be combined with the second trimester maternal serum screening tests (integrated screening) to obtain even higher levels of efficacy. There are, however, several practical limitations to first trimester and integrated screening. These include scheduling of testing within relatively narrow gestational age intervals, availability of appropriately trained ultrasonographers for NT measurement, risks associated with chorionic villus biopsy, and costs. There is also increasing evidence that an enlarged NT measurement is indicative of a high risk for spontaneous abortion and for fetal abnormalities that are not detectable by cytogenetic analysis. Women whose fetuses show enlarged NT, therefore, need first trimester counseling regarding their Down syndrome risks and the possibility of other adverse pregnancy outcomes. Follow-up ultrasound and fetal echocardiography in the second trimester are also indicated. First trimester

  11. Translucent insulating building envelope

    DEFF Research Database (Denmark)

    Rahbek, Jens Eg

    1997-01-01

    A new type of translucent insulating material has been tested. This material is made of Celulose-Acetat and have a honey-comb structure. The material has a high solar transmittance and is highly insulating. The material is relatively cheap to produce. Danish Title: Translucent isolerende klimaskærm....

  12. Performance of third-trimester ultrasound for prediction of small-for-gestational-age neonates and evaluation of contingency screening policies.

    Science.gov (United States)

    Souka, A P; Papastefanou, I; Pilalis, A; Michalitsi, V; Kassanos, D

    2012-05-01

    To assess the performance of third-trimester fetal biometry and fetal Doppler studies for the prediction of small-for-gestational-age (SGA) neonates, and to explore contingency strategies using a first-trimester prediction model based on maternal and fetal parameters and third-trimester ultrasound. This was an observational cross-sectional study of uncomplicated singleton pregnancies. Risk assessment for chromosomal abnormality was carried out in 4702 pregnancies using a combination of ultrasound markers (fetal nuchal translucency thickness (NT) and nasal bone assessment) and biochemistry (free beta-human chorionic gonadotropin (β-hCG) and pregnancy-associated plasma protein-A (PAPP-A)) at 11 to 13 + 6 weeks. Maternal demographic characteristics and method of conception were recorded. Third-trimester (30-34 weeks) fetal biometry (biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC) and femur length (FL)) and umbilical artery (UA) and middle cerebral artery Doppler studies were performed routinely in a subgroup (n = 2310). Reference ranges for birth weight were constructed using the cohort of 4702 women, and neonates were classified as small (SGA, ≤ 5th centile) or appropriate (AGA) for gestational age. First-trimester, third-trimester and integrated first- and third-trimester prediction models for SGA were constructed using regression analysis and three different contingency strategies of rescanning in the third trimester were investigated. According to the areas under the receiver-operating characteristics curves (AUCs), AC (AUC = 0.85) and ultrasound-estimated fetal weight (EFW, AUC = 0.87) were equally good predictors of SGA. The model was marginally improved by the addition of UA Doppler, smoking status and first-trimester indices (free β-hCG and PAPP-A multiples of the median) (combined model, AUC = 0.88), but the difference was not statistically significant. A contingency strategy of rescanning 50% of the population in the

  13. Changes in first trimester screening test parameters in pregnancies complicated by placenta previa and association with hyperemesis gravidarum.

    Science.gov (United States)

    Tülek, Fırat; Kahraman, Alper; Taşkın, Salih; Özkavukçu, Esra; Söylemez, Feride

    2014-01-01

    To assess the possible changes in first trimester screening test parameters in pregnancies complicated with placenta previa and to determine whether there is an association between hyperemesis gravidarum and placenta previa. A total of 131 singleton spontaneously conceived pregnancies that were complicated by placenta previa and delivered between May 2006 and May 2013 were evaluated from birth charts. Ninety patients without placenta previa were selected amongst patients who delivered within the same period of time as the control group. Cases of low lying placenta (n=52) within the study group were assessed as a separate group. The rest of the cases was considered to be in a different group. Beta human chorionic gonadotropin (BhCG) multiples of medians (MoMs) and nuchal translucency (NT) MoMs were significantly higher in the placenta previa group in comparison with the low lying placenta and control groups. Apgar scores at both the 1st and 5th minutes were significantly lower in the placenta previa group. Hyperemesis gravidarum was found to be significantly more frequent in the placenta previa group. The prevalence of hyperemesis gravidarum in the first trimester is higher in pregnancies complicated by placenta previa. Paying more attention to the development of placenta previa in the routine pregnancy follow-up of patients with hyperemesis gravidarum could be considered.

  14. Are there characteristics of the false-negative cases from the first trimester combined screening programme for Down syndrome?

    DEFF Research Database (Denmark)

    Hartwig, Tanja Schlaikjær; Sørensen, Steen; Jørgensen, Finn Stener

    2014-01-01

    based on screening results of false-negative cases. Screening results from false-negative cases show that maternal age is lower, nuchal translucency smaller, pregnancy-associated plasma protein-A level higher, β-human chorionic gonadotropin level lower and crown-rump length bigger than among true...... of false-negative cases tend toward the values of unaffected pregnancies with lower maternal age, smaller nuchal translucency, higher pregnancy-associated plasma protein-A level, lower β-human chorionic gonadotropin level and bigger crown-rump length than among true positive cases....

  15. First Trimester Aneuploidy Screening Markers in Women with Pre-Gestational Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    Padmalatha Gurram

    2014-05-01

    Full Text Available Objective: To investigate whether maternal serum pregnancy associated plasma protein-A (PAPP-A, total β human chorionic gonadotropin (hCG levels and nuchal translucency (NT measurements differ in women with pre-gestational diabetes mellitus (PGDM compared to non-diabetic controls and to assess whether correction factors are needed for diabetic women in calculation of aneuploidy risks. Study Design: We performed a retrospective study of all women who underwent first trimester aneuploidy screening (11 + 0 to 13 + 6 weeks from 2005 to 2011. The primary study outcome was the difference in PAPP-A, β-hCG and NT multiples of median between women with PGDM and non-diabetic women. Results: Of 6741 eligible patients, 103 patients with PGDM were using insulin and 4 patients were using oral hypoglycemic agents; the latter were excluded due to small number. There was 12% reduction of median PAPP-A (p = 0.001 and 18% reduction of median hCG (p = 0.006 in women with PGDM receiving insulin. There was no difference in NT. Conclusions: In women with PGDM receiving insulin, PAPP-A and β-hCG levels are significantly lower compared to non-diabetic women. This suggests that when calculating risks for aneuploidy, correction factors should be considered to adjust PAPP-A and β-hCG concentrations to those seen in non-diabetic women.

  16. Is Nuchal Cord a Perfect Scapegoat: A Retrospective Analysis from ...

    African Journals Online (AJOL)

    Mubeen

    Background: Entanglement of the umbilical cord around the fetal neck (nuchal cord) is quite a common finding at delivery. It is often assumed that nuchal cord causes cord compression and thus low birth weight and intrapartum complications. Aim: The aim of this article is to study the effect of nuchal cord on the mode of ...

  17. First-trimester measurement of the ductus venosus pulsatility index and the prediction of congenital heart defects

    NARCIS (Netherlands)

    Timmerman, E.; Clur, S. A.; Pajkrt, E.; Bilardo, C. M.

    2010-01-01

    Objective This study was carried out to evaluate the additional predictive value of ductus venosus pulsatility index for veins (DV-PIV) in the identification of congenital heart defects (CHDs) in fetuses with an enlarged nuchal translucency (NT) and a normal karyotype. Methods All chromosomally

  18. Ductus venosus in the first trimester: contribution to screening of chromosomal, cardiac defects and monochorionic twin complications.

    Science.gov (United States)

    Maiz, Nerea; Nicolaides, Kypros H

    2010-01-01

    In the first trimester the ductus venosus can be easily identified with color Doppler and a ductus venosus waveform can be obtained by pulsed Doppler. At 11-13 weeks the prevalence of abnormal a-wave in the ductus venosus is inversely related to fetal crown-rump length and maternal serum pregnancy-associated plasma protein-A (PAPP-A), increases with fetal nuchal translucency (NT) thickness and is more common in women of Black racial origin and in fetuses with abnormal karyotype or cardiac defects. Ductus venosus flow provides an independent contribution in the prediction of chromosomal abnormalities when combined with NT and the maternal serum markers of PAPP-A and free beta-hCG, increasing the detection rate to 96% at a false-positive rate of 2.6%. Abnormal ductus venosus flow increases the risk of cardiac defects in fetuses with NT above the 95th centile, and it may increase the risk in fetuses with normal NT. In twin pregnancies, abnormal ductus venosus flow is associated with chromosomal abnormalities and cardiac defects. In monochorionic twins, abnormal flow in the ductus venosus in at least 1 of the fetuses increases the risk of developing twin-to-twin transfusion syndrome. Copyright (c) 2010 S. Karger AG, Basel.

  19. Nuchal Translucency Measurement Did Not Significantly Predict Trisomy Cases in Tertiary Referral Center

    Directory of Open Access Journals (Sweden)

    Tülay Tos

    2012-12-01

    CONClUSION: This data led us to conclude that in our country there is still need for more accurate and standardized method to predict abnormal cases with higher sensitivity and specificiy to decrease invasive procedures.

  20. First trimester screening using ultrasound and serum markers in Panamanians : f0 actors associated with adverse pregnancy outcomes

    Directory of Open Access Journals (Sweden)

    Tania T Herrera

    2014-01-01

    Full Text Available Background: There is no published data on the association between serum biochemical and ultrasonographic markers and adverse pregnancy outcomes. Therefore, the aim of this study was to determine the factors associated with perinatal outcomes in singleton pregnancies using ultrasound and maternal serum markers during the first trimester in Panamanians. Materials and Methods: This was a prospective observational study of 468 first trimester singleton pregnancies conducted over a 7-year period. All women attending a prenatal screening clinic during the study period were informed of the study and the option to participate. Two maternal serum markers, free β-human chorionic gonadotropin (β-hCG and pregnancy associated plasma protein-A (PAPP-A, and four fetal ultrasound markers, nuchal translucency thickness, nasal bone, flow across the tricuspid valve, and flow in the ductus venosus (DV, were measured by certified maternal fetal medicine specialists. Adverse outcomes included miscarriage, major structural defects, genetic disorders, and major fetal cardiac defects. Results: A total of 454 (97% pregnancies were unaffected. Median maternal age was 31.5 years (range: 18-50. Maternal age was significantly greater in cases of adverse outcome (P = 0.007. The number of adverse outcomes associated with an absent or hypoplastic nasal bone, tricuspid valve regurgitation, and abnormal flow in the DV were significantly greater relative to unaffected pregnancies (Ps < 0.001. No differences were found in fetal crown-rump length or maternal serum levels of β-hCG or PAPP-A. Conclusion: Abnormal ultrasound markers are associated with adverse outcomes. Women with normal ultrasound and serum markers should be reassured of low risk of adverse pregnancy outcomes.

  1. Principles of first trimester screening in the age of non-invasive prenatal diagnosis: screening for chromosomal abnormalities.

    Science.gov (United States)

    Kagan, Karl Oliver; Sonek, Jiri; Wagner, Philipp; Hoopmann, Markus

    2017-10-01

    First trimester risk assessment for chromosomal abnormalities plays a major role in the contemporary pregnancy care. It has evolved significantly since its introduction in the 1990s, when it essentially consisted of just the nuchal translucency measurement. Today, it involves the measurement of several biophysical and biochemical markers and it is often combined with a cell-free DNA (cfDNA) analysis as a secondary test. A search of the Medline and Embase databases was done looking for articles about first trimester aneuploidy screening. We performed a detailed review of the literature to evaluate the screening tests currently available and their respective test performance. Combined screening for trisomy 21 based on maternal age, fetal NT, and the serum markers free beta-hCG and PAPP-A results in a detection rate of about 90% for a false positive of 3-5%. With the addition of further ultrasound markers, the false positive rate can be roughly halved. Screening based on cfDNA identifies about 99% of the affected fetuses for a false positive rate of 0.1%. However, there is a test failure rate of about 2%. The ideal combination between combined and cfDNA screening is still under discussion. Currently, a contingent screening policy seems most favorable where combined screening is offered for everyone and cfDNA analysis only for those with a borderline risk result after combined screening. Significant advances in screening for trisomy 21 have been made over the past 2 decades. Contemporary screening policies can detect for more than 95% of affected fetuses for false positive rate of less than 3%.

  2. Improved first-trimester Down syndrome screening performance by lowering the false-positive rate: a prospective study of 9941 low-risk women

    DEFF Research Database (Denmark)

    Wøjdemann, K R; Shalmi, A C; Christiansen, M

    2005-01-01

    OBJECTIVE: To determine the performance of screening for Down syndrome (DS) and other major chromosomal abnormalities using nuchal translucency (NT), free beta-human chorionic gonadotropin (beta-hCG) and pregnancy-associated plasma protein-A (PAPP-A) in a prospective study of a non...

  3. The prognostic value of the nuchal cord prenatal diagnosis

    African Journals Online (AJOL)

    2009-08-28

    Aug 28, 2009 ... Andres RL, Lewandowski MS, Peltier MR. Markers of chronic hypoxia in pregnancies complicated by nuchal cord. Am J Obstet Gynecol 2004; 191(6): S134. 14. Peregrine E, O'Brien P, Jauniaux E. Ultrasound detection of nuchal cord prior to labor induction and the risk of Cesarean section. Ultrasound ...

  4. Aneuploidy screening during pregnancy by a three-dimensional Advanced First Trimester Screening model: description of the AFS-3D algorithm.

    Science.gov (United States)

    Schmidt, Peter; Hörmansdörfer, Cindy; Vaske, Bernhard; Hillemanns, Peter; Scharf, Alexander

    2012-02-01

    A novel screening method for fetal aneuploidies was developed, in which nuchal translucency (NT), pregnancy-associated plasma protein-A (PAPP-A), and free-β human chorionic gonadotropin (free-β hCG) are placed into a three-dimensional scatter plot. Likelihood ratios are directly inferred from the ratio of already observed healthy and diseased fetuses. This method is called 'Three-dimensional Advanced First trimester Screening' (AFS-3D). It was aimed to develop and test a new algorithm based on the results of previous studies. A new static-sized sphere model was developed. Several scaling factors of the axes and the optional application of the modifications 'simulation' (SIM) and 'empty sphere positive' were tested on 15,227 data sets. An additional examination was performed on a second collective (n = 458). The application of the new AFS-3D model with static-sized spheres, a re-sampled ∆NT axis by a scaling factor of 0.125, and the application of SIM and Empty Box Positive resulted in a marked improvement of the test performance (area under curve, AUC = 0.9668). Analogous results (AUC = 0.9807) were found for the second test collective. This novel approach is promising and should be tested on a larger, independent collective. © 2012 John Wiley & Sons, Ltd.

  5. First Trimester Maternal Serum Screening Using Biochemical Markers PAPP-A and Free β-hCG for Down Syndrome, Patau Syndrome and Edward Syndrome.

    Science.gov (United States)

    Shiefa, S; Amargandhi, M; Bhupendra, J; Moulali, S; Kristine, T

    2013-01-01

    The first trimester screening programme offers a noninvasive option for the early detection of aneuploidy pregnancies. This screening is done by a combination of two biochemical markers i.e. serum free β-human chorionic gonadotrophin (free β-hCG) and pregnancy associated plasma protein A (PAPP-A), maternal age and fetal nuchal translucency (NT) thickness at 11 + 0-13 + 6 weeks of gestation. A beneficial consequence of screening is the early diagnosis or trisomies 21, 18 and 13. At 11 + 0-13 + 6 weeks, the relative prevalence of trisomies 18 and 13 to trisomy 21 are found to be one to three and one to seven, respectively. All three trisomies are associated with increased maternal age, increased fetal NT and decreased PAPP-A, but in trisomy 21 serum free β-hCG is increased whereas in trisomies 18 and 13 free β-hCG is decreased.

  6. Fetal volume measurements with three dimensional ultrasound in the first trimester of pregnancy, related to pregnancy outcome, a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Smeets Nicol AC

    2012-05-01

    Full Text Available Abstract Background First trimester growth restriction is associated with an increased risk of adverse birth outcomes (preterm birth, low birth weight and small for gestational age at birth. The differences between normal and abnormal growth in early pregnancy are small if the fetal size is measured by the crown-rump-length. Three-dimensional ultrasound volume measurements might give more information about fetal development than two-dimensional ultrasound measurements. Detection of the fetus with a small fetal volume might result in earlier detection of high risk pregnancies and a better selection of high risk pregnancies. Methods A prospective cohort study, performed at the Máxima Medical Centre, in Eindhoven-Veldhoven, the Netherlands. During the routine first trimester scan with nuchal translucency measurement 500 fetal volumes will be obtained. The gestational age is based on the first day of the last menstrual period in a regular menstrual cycle and by the crown-rump-length. The acquired datasets are collected and stored on a hard disk for offline processing and volume calculation. The investigator who performs the volume measurements is blinded for the results of the first trimester scan. The manual mode will be used to outline the Region Of Interest, the fetal head and rump, in all cross sections. The fetal volumes are calculated with a rotational step of 9°. First, the relation between fetal volume and gestational age, for a set of participants with normal pregnancies (training set, will be assessed. This model will then be used to determine expected values of fetal volume for a normal pregnancy, which will be referred to as expected normal values. Secondly, for a new set of participants with normal pregnancies and a set of participants with complicated pregnancies (together defined as validation set, the observed fetal volumes (FVobserved are compared with their expected normal values (FVexpected and expressed as a percentage of the

  7. Basic heart examination: feasibility study of first-trimester systematic simplified fetal echocardiography.

    Science.gov (United States)

    Quarello, E; Lafouge, A; Fries, N; Salomon, L J

    2017-02-01

    First-trimester fetal cardiac screening examinations in low-risk populations should not have to meet the specifications required for high-risk populations. Our aim was to evaluate a simplified fetal echocardiographic ('basic heart') examination for early detection of severe congenital heart defects in a low-risk population. This was a first-trimester national 'flash study', performed over a 2-week period. Each observer was requested to perform simplified echocardiography without modifying the time and methods deemed necessary for the routine first-trimester ultrasound examination, in fetuses with crown-rump length between 45 and 84 mm. This basic heart assessment used targeted cross-sections of the four-chamber view (4CV) and of the three vessels and trachea (3VT) view, using color and/or directional power Doppler. All examinations were then reviewed offline and scored for quality by a qualified expert. Sixty observers performed a total of 597 first-trimester ultrasound examinations, each performing an average of 10 (range, 1-26) procedures. Examinations were conducted transabdominally (79%; 472/597), transvaginally (3%; 17/597) or both (18%; 108/597). In 8% (45/597) of cases, the fetal back was anterior, in 18% (108/597) it was on the left side, in 63% (377/597) it was posterior and in 11% (67/597) it was on the right side. It became clear during scoring by the expert that, unlike the Herman quality score for nuchal translucency measurement, it was difficult to assess the quality of these images without taking into account normality of the heart itself. Analysis of scores showed that the 4CV was obtained successfully and was deemed normal in 86% (512/597) of the patients, in 7% (41/597) it was deemed technically infeasible and in 7% (44/597) it was deemed feasible but atypical, which may have been due to the presence of an abnormality or to poor quality of the image. The 3VT view was obtained successfully and was normal in 79% (472/597) of the patients, in 13

  8. Translucency and Strength of High Translucency Monolithic Zirconium Oxide Materials

    Science.gov (United States)

    2016-05-17

    sintered and polished according to the manufacturer’s instructions (n=5). Translucency parameter was calculated using a spectrophotometer (VITA Easyshade...manufacturing metal -ceramic restorations which had strength and accuracy due to the cast metal , but also provided esthetically pleasing results because...of the ceramic (Shillingburg et al. , 1997). For years, dentists have used metal -ceramic crowns to provide their patients with strong, long lasting

  9. Effect of core/veneer thickness ratio and veneer translucency on absolute and relative translucency of CAD-On restorations

    Directory of Open Access Journals (Sweden)

    Mennatallah Mohie el-Din Wahba, (BDS, MSc

    2017-06-01

    Conclusions: Only veneer translucency had significant effect over contrast ratio values, while on the other hand, absolute translucency values were significantly affected by the core/veneer thickness ratio, veneer translucency and interaction between them. It was clear that absolute translucency measurements showed higher translucency values for the restorations than contrast ratio measurements.

  10. PREVIOUS SECOND TRIMESTER ABORTION

    African Journals Online (AJOL)

    PNLC

    PREVIOUS SECOND TRIMESTER ABORTION: A risk factor for third trimester uterine rupture in three ... for accurate diagnosis of uterine rupture. KEY WORDS: Induced second trimester abortion - Previous uterine surgery - Uterine rupture. ..... scarred uterus during second trimester misoprostol- induced labour for a missed ...

  11. Diffuse and goniochromatic reflectance of translucent materials

    Science.gov (United States)

    Chirdon, William M.

    Although the mechanical stability of dental restorations remains a priority, research is currently being pursued to improve the esthetics of restorations. This includes the technology of color matching and the general understanding of the appearance of natural teeth. Before the appearance of natural teeth can be mimicked, it must first be reduced to quantifiable parameters. Teeth and dental restorations typically have their appearance defined by their three-dimensional color, which then becomes the basis for appearance matching. However, standard color measurements cannot account for differences in translucency between materials, while a human observer readily can. Furthermore, teeth are translucent, multi-layered, biological composites that have aligned microstructures. These translucent layers and aligned microstructure make the color dependant upon the observation angle---a property known as goniochromism. This research shows how translucent materials exhibit significant goniochromatic behaviors. Since the translucency typically results in goniochromatic behavior, goniochromatic behavior is thought to be how translucency is perceived, and consequently, how color matching in translucent materials can potentially fail to match the appearance. To better understand the causes of goniochromism, fiber filler alignment, layering, and specularly reflecting backings were investigated as mechanisms of goniochromism. These same three mechanisms are also likely to affect the diffuse reflectance of translucent materials, which were also quantitatively studied. Another particularly odd property of human enamel is its ability to produce multiple-slit, Fraunhofer diffraction patterns, which this work reproduced using aligned, E-glass-fiber composites.

  12. Ultrasonographic soft markers of aneuploidy in second trimester fetuses

    Directory of Open Access Journals (Sweden)

    Mohammed Khairy Ali

    2012-09-01

    Introduction: Chromosomal abnormalities occur in 0.1–0.2% of live births, and the most common clinically significant aneuploidy among live-born infants is Down’s syndrome (trisomy 21. Soft markers of aneuploidy are nonspecific, often transient, and can be readily detected during the second and third trimester ultrasound. The most commonly studied soft markers of aneuploidy include a thickened nuchal fold, mild fetal pyelectasis, echogenic bowel, echogenic intracardiac focus and choroid plexus cyst. There is a great deal of interest in the ultrasound detection of aneuploidy, as evidenced by the large number of publications in the literature on this topic.

  13. First-trimester sonographic prediction of obstetric and neonatal outcomes in monochorionic diamniotic twin pregnancies.

    Science.gov (United States)

    Allaf, M Baraa; Vintzileos, Anthony M; Chavez, Martin R; Wax, Joseph A; Ravangard, Samadh F; Figueroa, Reinaldo; Borgida, Adam; Shamshirsaz, Amir; Markenson, Glenn; Davis, Sarah; Habenicht, Rebecca; Haeri, Sina; Ozhand, Ali; Johnson, Jeffery; Sangi-Haghpeykar, Haleh; Spiel, Melissa; Ruano, Rodrigo; Meyer, Marjorie; Belfort, Michael A; Ogburn, Paul; Campbell, Winston A; Shamshirsaz, Alireza A

    2014-01-01

    The purpose of this study was to investigate whether discordant nuchal translucency and crown-rump length measurements in monochorionic diamniotic twins are predictive of adverse obstetric and neonatal outcomes. We conducted a multicenter retrospective cohort study including all monochorionic diamniotic twin pregnancies with two live fetuses at the 11-week to 13-week 6-day sonographic examination who had serial follow-up sonography until delivery. Isolated nuchal translucency, crown-rump length, and combined discordances were correlated with adverse obstetric outcomes, individually and in composite, including the occurrence of 1 or more of the following in either fetus: intrauterine growth restriction (IUGR), twin-twin transfusion syndrome (TTTS), intrauterine fetal death (IUFD), growth discordance (≥ 20%), and preterm birth before 28 weeks' gestation. Correlations with adverse composite neonatal outcomes were also studied. A receiver operating characteristic curve analysis and a logistic regression analysis with a generalized estimating equation were conducted. Fifty-four of the 177 pregnancies included (31%) had an adverse composite obstetric outcome, with TTTS in 19 (11%), IUGR in 21 (12%), discordant growth in 14 (8%), IUFD in 14 (8%), and preterm birth before 28 weeks in 10 (6%). Of the 254 neonates included in the study, 69 (27%) were complicated by adverse composite neonatal outcomes, with respiratory distress syndrome being the most common (n = 59 [23%]). The areas under the curve for the combined discordances to predict composite obstetric and neonatal outcomes were 0.62 (95% confidence interval, 0.52-0.72), and 0.54 (95% confidence interval, 0.46-0.61), respectively. In our population, nuchal translucency, crown-rump length, and combined discordances in monochorionic diamniotic twin pregnancies were not predictive of adverse composite obstetric and neonatal outcomes.

  14. Is Nuchal Cord a Perfect Scapegoat: A Retrospective Analysis from ...

    African Journals Online (AJOL)

    Aim: The aim of this article is to study the eff ect of nuchal cord on the mode of delivery, complications and fetal outcome. Materials and Methods: A ... the chances of cesarean delivery. However, tight cord around the neck may result in low Apgar scores and increased incidence of fetal distress leading to cesarean section.

  15. The prognostic value of the nuchal cord prenatal diagnosis ...

    African Journals Online (AJOL)

    Objective. To verify whether postnatal results for newborns can be improved if the abdominal mode of delivery is used for all cases of umbilical cord loops diagnosed ante partum. Method. We compared the obstetric results for two groups of births: 344 vaginal deliveries in which nuchal cord was diagnosed during the second ...

  16. Study on the nuchal ligament ossification on lateral cephalometric radiograph

    International Nuclear Information System (INIS)

    An, Chang Hyeon

    2009-01-01

    The purpose of this study was to assess the prevalence and radiographic characteristics of the nuchal ligament ossification on lateral cephalometric radiographs in Koreans. I review and interpreted the lateral cephalometric radiographs from 4,558 patients (1,857 males and 2,701 females, age range from 2 to 79 years) who visited the Kyungpook National University Dental Hospital from January 1, 2008 to February 3, 2009. I grouped the shapes of nuchal ligament ossification as round, rod-like, and segmented shape. And localized the ossification as the involvement of anterior cervical vertebral body. The data were analyzed by using chi-squared test with two-tailed and at a 5% significance level. Among those who showed the nuchal ligament ossification, the mean age of the 143 males was 51.1 and that of the 97 females was 48.0 years. It was not observed completely below teens, and was observed 1% in twenties, 6.1% in thirties, 18.6% in forties, and 26.3% over fifties. It was significantly prevalent in older age group (P<0.01) and in males than females among the same age group (P<0.05). The shapes of nuchal ligament ossification were as follows in order of frequency : rod-like (49.2%), round (30.4%), and segmented (20.4%). The highest involvement of ossification was found at the level of C5 (67.9%), C4 (29.2%), C6 (22.9%), C3 (3.3%), C7 (2.9%), C2 (0.8%), and C1 (0.4%). The nuchal ligament ossifications on lateral cephalometric radiographs were showed as round, rodlike, or segmented shape. The nuchal ligament ossification is often observed after the age of 40 and is observed more frequently in males than females. The highest shape of nuchal ligament ossification was rod-like shape and the highest involvement of cervical spine was C5.

  17. PAHs in Translucent Interstellar Clouds

    Science.gov (United States)

    Salama, Farid; Galazutdinov, G.; Krelowski, J.; Biennier, L.; Beletsky, Y.; Song, I.

    2011-05-01

    We discuss the proposal of relating the origin of some of the diffuse interstellar bands (DIBs) to neutral polycyclic aromatic hydrocarbons (PAHs) present in translucent interstellar clouds. The spectra of several cold, isolated gas-phase PAHs have been measured in the laboratory under experimental conditions that mimic the interstellar conditions and are compared with an extensive set of astronomical spectra of reddened, early type stars. This comparison provides - for the first time - accurate upper limits for the abundances of specific PAH molecules along specific lines-of-sight. Something that is not attainable from IR observations alone. The comparison of these unique laboratory data with high resolution, high S/N ratio astronomical observations leads to two major findings: (1) a finding specific to the individual molecules that were probed in this study and, which leads to the clear and unambiguous conclusion that the abundance of these specific neutral PAHs must be very low in the individual translucent interstellar clouds that were probed in this survey (PAH features remain below the level of detection) and, (2) a general finding that neutral PAHs exhibit intrinsic band profiles that are similar to the profile of the narrow DIBs indicating that the carriers of the narrow DIBs must have close molecular structure and characteristics. This study is the first quantitative survey of neutral PAHs in the optical range and it opens the way for unambiguous quantitative searches of PAHs in a variety of interstellar and circumstellar environments. // Reference: F. Salama et al. (2011) ApJ. 728 (1), 154 // Acknowledgements: F.S. acknowledges the support of the NASA's Space Mission Directorate APRA Program. J.K. acknowledges the financial support of the Polish State (grant N203 012 32/1550). The authors are deeply grateful to the ESO archive as well as to the ESO staff members for their active support.

  18. Translucency of dental ceramics with different thicknesses.

    Science.gov (United States)

    Wang, Fu; Takahashi, Hidekazu; Iwasaki, Naohiko

    2013-07-01

    The increased use of esthetic restorations requires an improved understanding of the translucent characteristics of ceramic materials. Ceramic translucency has been considered to be dependent on composition and thickness, but less information is available about the translucent characteristics of these materials, especially at different thicknesses. The purpose of this study was to investigate the relationship between translucency and the thickness of different dental ceramics. Six disk-shaped specimens of 8 glass ceramics (IPS e.max Press HO, MO, LT, HT, IPS e.max CAD LT, MO, AvanteZ Dentin, and Trans) and 5 specimens of 5 zirconia ceramics (Cercon Base, Zenotec Zr Bridge, Lava Standard, Lava Standard FS3, and Lava Plus High Translucency) were prepared following the manufacturers' instructions and ground to a predetermined thickness with a grinding machine. A spectrophotometer was used to measure the translucency parameters (TP) of the glass ceramics, which ranged from 2.0 to 0.6 mm, and of the zirconia ceramics, which ranged from 1.0 to 0.4 mm. The relationship between the thickness and TP of each material was evaluated using a regression analysis (α=.05). The TP values of the glass ceramics ranged from 2.2 to 25.3 and the zirconia ceramics from 5.5 to 15.1. There was an increase in the TP with a decrease in thickness, but the amount of change was material dependent. An exponential relationship with statistical significance (Pceramics and zirconia ceramics. The translucency of dental ceramics was significantly influenced by both material and thickness. The translucency of all materials increased exponentially as the thickness decreased. All of the zirconia ceramics evaluated in the present study showed some degree of translucency, which was less sensitive to thickness compared to that of the glass ceramics. Copyright © 2013 The Editorial Council of the Journal of Prosthetic Dentistry. Published by Mosby, Inc. All rights reserved.

  19. Is there a role for cervical assessment and uterine artery Doppler in the first trimester of pregnancy as a screening test for spontaneous preterm delivery?

    Science.gov (United States)

    Parra-Cordero, M; Sepúlveda-Martínez, A; Rencoret, G; Valdés, E; Pedraza, D; Muñoz, H

    2014-03-01

    To evaluate the role of cervical length (CL) and uterine artery pulsatility index (UtA-PI) at 11+0 to 13+6 weeks as predictors of spontaneous preterm delivery (sPTD) in a Chilean population. This was a prospective study of asymptomatic women with singleton pregnancies attending for a nuchal translucency scan at 11+0 to 13+6 weeks' gestation and who underwent a transvaginal scan for evaluation of CL and UtA-PI. Exclusion criteria were fetal and pregnancy complications (other than sPTD) and iatrogenic delivery atUtA-PI were adjusted for fetal crown-rump length and maternal characteristics and expressed as multiples of the median (MoM) of the unaffected group. Prediction of sPTD using maternal and pregnancy characteristics was studied using logistic regression analysis. A total of 3480 women were recruited into the study and, after application of exclusion criteria, 3310 were included in the analysis. The rate of sPTD atUtA-PI between pregnancies with and without subsequent sPTD. Logistic regression analysis showed that smoking and previous PTD were significantly associated with sPTD atUtA-PI nor CL during the first trimester was shown to be a useful predictor of early sPTD. However, a combined model that includes smoking and previous PTD predicts approximately one-quarter of those women destined to deliver at<34 weeks, with a false-positive rate of 8%. Copyright © 2013 ISUOG. Published by John Wiley & Sons Ltd.

  20. First-trimester risk calculation for trisomy 13, 18, and 21: comparison of the screening efficiency between 2 locally developed programs and commercial software.

    Science.gov (United States)

    Sørensen, Steen; Momsen, Günther; Sundberg, Karin; Friis-Hansen, Lennart; Jørgensen, Finn Stener

    2011-07-01

    Reliable individual risk calculation for trisomy (T) 13, 18, and 21 in first-trimester screening depends on good estimates of the medians for fetal nuchal translucency thickness (NT), free β-subunit of human chorionic gonadotropin (hCGβ), and pregnancy-associated plasma protein-A (PAPP-A) in maternal plasma from unaffected pregnancies. Means and SDs of these parameters in unaffected and affected pregnancies are used in the risk calculation program. Unfortunately, our commercial program for risk calculation (Astraia) did not allow use of local medians. We developed 2 alternative risk calculation programs to assess whether the screening efficacies for T13, T18, and T21 could be improved by using our locally estimated medians. We established these estimates from 19 594 women with singleton pregnancies and from 100 pregnant women carrying a fetus affected with trisomy (11 with T13, 23 with T18, and 66 with T21). All measured values were recalculated to a multiple of the median (MoM) and log(10) transformed; the mean and SD were calculated for each group. At a given risk cutoff value, we observed a slight improvement in detection rate (DR) for T13, T18, and T21 for a slightly higher false-positive rate (FPR) compared with the commercial program. The lower FPR in the commercial program was caused mainly by an inaccuracy in the PAPP-A median. Center-specific medians for NT, hCGβ, and PAPP-A should be used in risk calculation programs to ensure high DRs and low FPRs for all 3 trisomies at a given risk cutoff.

  1. Influence of Second-Trimester Ultrasound Markers for Down Syndrome in Pregnant Women of Advanced Maternal Age

    Directory of Open Access Journals (Sweden)

    Mariza Rumi Kataguiri

    2014-01-01

    Full Text Available The objective of the present study was to evaluate the influence of second-trimester ultrasound markers on the incidence of Down syndrome among pregnant women of advanced maternal age. This was a retrospective cohort study on 889 singleton pregnancies between the 14th and 30th weeks, with maternal age ≥ 35 years, which would undergo genetic amniocentesis. The second-trimester ultrasound assessed the following markers: increased nuchal fold thickness, cardiac hyperechogenic focus, mild ventriculomegaly, choroid plexus cysts, uni- or bilateral renal pyelectasis, intestinal hyperechogenicity, single umbilical artery, short femur and humerus length, hand/foot alterations, structural fetal malformation, and congenital heart disease. To investigate differences between the groups with and without markers, nonparametric tests consisting of the chi-square test or Fisher’s exact test were used. Moreover, odds ratios with their respective 95% confidence intervals were calculated. Out of the 889 pregnant women, 131 (17.3% presented markers and 758 (82.7% did not present markers on the second-trimester ultrasound. Increased nuchal fold (P<0.001 and structural malformation (P<0.001 were the markers most associated with Down syndrome. The presence of one marker increased the relative risk 10.5-fold, while the presence of two or more markers increased the risk 13.5-fold. The presence of markers on the second-trimester ultrasound, especially thickened nuchal fold and structural malformation, increased the risk of Down syndrome among pregnant women with advanced maternal age.

  2. Increased nuchal translucency with normal karyotype: a follow-up study of 100 cases supplemented with CGH and MLPA analyses

    DEFF Research Database (Denmark)

    Schou, K V; Kirchhoff, M; Nygaard, U

    2009-01-01

    karyotype on conventional karyotyping. METHODS: Chorionic villus samples from 100 fetuses with NT > or = 99(th) percentile and normal G-banding analysis and MLPA for detection of aneuploidies for chromosomes 13, 18, 21, X and Y were included. Examinations were supplemented by HR-CGH and MLPA for syndromes...... disease, which supports the current approach of repeated ultrasound examinations in these high-risk pregnancies....

  3. GENERATION OF TRANSLUCENT LANGUAGE BY SUPERIMPOSITION OPERATION

    Directory of Open Access Journals (Sweden)

    C Annal Deva Priya Darshini

    2017-07-01

    Full Text Available We have introduced a new operation called the superimposition operation. The translucent language generated by a given superimposition operation and a language L is the set of words generated by the superimposition of any two words in L. In this paper we study the properties of translucent languages. We also introduce a variant of the operation called Superimposition under control. We examine the properties of languages under this operation

  4. Ultrastructure of the extensively developed nuchal organs of Laonice bahusiensis (Annelida: Canalipalpata: Spionidae).

    Science.gov (United States)

    Jelsing, Jacob; Eibye-Jacobsen, Danny

    2010-03-01

    The nuchal organs of annelid Laonice bahusiensis (Spionidae) from northern Europe have been studied using scanning and transmission electron microscopy. L. bahusiensis is the first spionid species in which extensively developed, continuous nuchal organs are described. The nuchal organs of this genus are the longest known among polychaete annelids. They consist of paired double bands extending from the prostomium on a mid-dorsal caruncle for about 24-30 setigers. Their microanatomy corresponds to the general structural plan of nuchal organs: there are ciliated supporting cells and bipolar sensory cells with sensory cilia traversing an olfactory chamber. The organs are overlaid by a secondary paving-stone-like cover and innervated by one pair of longitudinally elongated nuchal nerves. These findings clearly favor the hypothesis that the paired, extensively developed ciliated structures found in some Spionidae are homologous with the prostomial nuchal organs characteristic of polychaete annelids.

  5. Effect of shading technique and thickness on color stability and translucency of new generation translucent zirconia.

    Science.gov (United States)

    Alp, Gülce; Subaşı, Meryem Gülce; Seghi, Robert R; Johnston, William M; Yilmaz, Burak

    2018-03-27

    To evaluate the effect of shading technique and thickness on the color stability and translucency of translucent zirconia after coffee thermocycling. Specimens in different thicknesses (1; 1.5; 2 mm) (n = 4 for each thickness) were sectioned from translucent preshaded zirconia (Pre) and externally shaded zirconia (Ext). After sintering, specimens were glazed and subjected to 10,000 thermocycling in coffee solution. The color coordinates of specimens were measured with a spectroradiometer before and after coffee thermocyling. Color differences and relative translucency parameter (RTP) values were calculated with CIEDE2000 color difference and TP CIEDE2000 formulas. ANOVA was used to analyze the CIEDE2000 color difference and RTP values (α = 0.05). According to 2-way ANOVA, no significant effect of shading technique and thickness on the color difference values was found (P > .05). According to 3-way ANOVA, a significant interaction between the shading technique and thickness (P < .0001) was found for RTP. The RTP parameter decreased with the increase in the thickness. Ext specimens presented significantly higher RTP than Pre specimens (P < .0001), except for between Ext 1 mm and Pre 1 mm (P = .179). Neither shading technique nor tested thicknesses affected the color of translucent zirconia. Shading technique and thickness affected the RTP of translucent zirconia. The RTP was inversely affected with the thickness of the material. Externally shaded zirconia presented higher RTP than preshaded zirconia for specimens thicker than 1 mm. Discoloration with coffee was insignificant for the tested translucent zirconia in tested thicknesses (1, 1.5, 2 mm). When a translucent restoration is intended, thinner externally shaded translucent zirconia restorations should be preferred instead of preshaded translucent zirconia. Copyright © 2018 Elsevier Ltd. All rights reserved.

  6. Nuchal crest avulsion fracture in 2 horses : a cause of headshaking : clinical communication

    Directory of Open Access Journals (Sweden)

    A. Voigt

    2009-05-01

    Full Text Available The medical records of 2 Thoroughbred horses that developed headshaking after blunt trauma to the occipital region are reviewed. The history, signalment, clinical signs, diagnostic methods, diagnosis and treatment were recorded in each case. Both horses displayed headshaking, while one horse repeatedly lifted its upper lip and pawed excessively at the ground. In both horses, diagnostic imaging of the occipital region revealed avulsion fragments of the nuchal crest and a nuchal desmitis in association with hyperfibrinogenaemia. The presence of an avulsion fragment of the nuchal crest with associated nuchal desmitis should be considered in horses presenting with headshaking and may respond favourably to conservative therapy.

  7. First-trimester risk assessment based on ultrasound and cell-free DNA vs combined screening: a randomized controlled trial.

    Science.gov (United States)

    Kagan, K O; Sroka, F; Sonek, J; Abele, H; Lüthgens, K; Schmid, M; Wagner, P; Brucker, S; Wallwiener, D; Hoopmann, M

    2017-09-19

    This was a randomized controlled trial to compare risk assessment by first-trimester combined screening (FTCS) with an approach that combines a detailed ultrasound examination at 11-13 weeks' gestation and cell-free DNA (cfDNA) analysis. Pregnant women with a normal first-trimester ultrasound examination at 11-13 weeks' gestation (fetal nuchal translucency (NT) ≤ 3.5 mm and no fetal defects) were randomized into one of two groups. In the first group, risk of aneuploidy was assessed using FTCS based on the most recent UK Fetal Medicine Foundation algorithm. In the second group, risk assessment was based on ultrasound findings and cfDNA analysis. An additional tube of blood was collected for FTCS in case the cfDNA analysis was uninformative. Primary outcome was false-positive rate in screening for trisomy 21. A case was considered false positive if the karyotype was not trisomy 21 and if the risk for trisomy 21 was >1:100, irrespective of the method of risk calculation. Results were compared using 95% CIs using the Clopper-Pearson method. Between October 2015 and December 2016, 1518 women with singleton pregnancy underwent first-trimester screening. Thirty-one (2.0%) pregnancies were not eligible for randomization due to increased NT (> 3.5 mm) and/or fetal defect. After exclusion of women who declined randomization (n = 87) and cases of fetal death and loss to follow-up (n = 24), 688 pregnancies were randomized into the FTCS arm and 688 into the ultrasound + cfDNA analysis arm. There were no differences in maternal and gestational age, maternal weight and BMI, ethnicity, use of assisted reproduction and cigarette smoking between the two arms. In the ultrasound + cfDNA analysis arm, median risk for trisomy 21 was 1 in 10 000. None of the cases had a risk above 1: 100 (95% CI, 0.0-0.5%). In the FTCS arm, the median risk for trisomy 21 was 1 in 3787 and in 17 cases, the risk was higher than 1:100, which corresponds to 2.5% (95% CI, 1.5-3.9%) of

  8. Making yttria-stabilized tetragonal zirconia translucent

    Science.gov (United States)

    Zhang, Yu

    2014-01-01

    Objective The aim of this study was to provide a design guideline for developing tetragonal yttria-stabilized zirconia with improved translucency. Methods The translucency, the in-line transmission in particular, of 3 mol.% yttria-stabilized tetragonal zirconia (3Y-TZP) has been examined using the Rayleigh scattering model. The theory predicts that the in-line transmission of 3Y-TZP can be related to its thickness with grain size and birefringence the governing parameters. To achieve a threshold value of translucency, the critical grain size of 3Y-TZP was predicted for various thicknesses (0.3 – 2.0 mm). The threshold value was defined by a measured average in-line transmission value of a suite of dental porcelains with a common thickness of 1 mm. Our theoretical predictions were calibrated with one of the very few experimental data available in the literature. Results For a dense, high-purity zirconia, its in-line transmission increased with decreasing grain size and thickness. To achieve a translucency similar to that of dental porcelains, a nanocyrstalline 3Y-TZP structure was necessitated, due primarily to its large birefringence and high refractive index. Such a grain size dependence became more pronounced as the 3Y-TZP thickness increased. For example, at a thickness of 1.3 mm, the mean grain size of a translucent 3Y-TZP should be 82 nm. At 1.5 mm and 2 mm thicknesses, the mean grain size needed to be 77 nm and 70 nm, respectively. Significance A promising future for zirconia restorations, with combined translucency and mechanical properties, can be realized by reducing its grain size. PMID:25193781

  9. Effect of accelerated aging on translucency of monolithic zirconia

    Directory of Open Access Journals (Sweden)

    O. Abdelbary

    2016-12-01

    Conclusion: Thickness of zirconia has significant effect on translucency. Aging has significant effect on thinner sections of zirconia. More research is required on zirconia towards making the material more translucent for its potential use as esthetic monolithic restoration.

  10. Role of uterine artery Doppler in interpreting low PAPP-A values in first-trimester screening for Down syndrome in pregnancies at high risk of impaired placentation.

    Science.gov (United States)

    Herraiz, I; López-Jiménez, E A; García-Burguillo, A; Nieto, O; Villar, O P; Escribano, D; Galindo, A

    2009-05-01

    Low maternal serum levels of pregnancy-associated plasma protein-A (PAPP-A) are associated with both increased risk of aneuploidies and impaired trophoblastic invasion, while high uterine artery (UtA) resistance is associated with impaired trophoblastic invasion but not with an increased risk of aneuploidies. The aim of this study was to determine whether high UtA resistance plays a role in explaining low PAPP-A levels in the absence of aneuploidies. This was a prospective study of 116 singleton pregnancies at high risk for impaired placentation (having at least one major risk factor: prior history of pre-eclampsia, pregestational diabetes mellitus, chronic hypertension, chronic kidney disease, body mass index >30, autoimmune disorder, thrombophilia or recurrent pregnancy loss), booked for routine assessment of risk for aneuploidies by means of the first-trimester combined screening test (nuchal translucency thickness (NT) + PAPP-A + beta-human chorionic gonadotropin (beta-hCG)). Measurement of NT and the mean UtA pulsatility index (PI) were carried out at the 11 to 13 + 6-week scan. All values were calculated in multiples of the median (MoM) adjusted for gestational age. A cut-off risk of 1/270 at time of sampling was adopted to differentiate high- from low-risk groups for trisomy 21. There were 108 patients deemed to be at low risk for trisomy 21 and eight at high risk. None had chromosomal defects, giving a false-positive rate for trisomy 21 of 6.9%. The greatest differences between patients at low risk and those at high risk for trisomy 21 were found in their PAPP-A (0.98 vs. 0.38 MoM, P UtA-PI (1.05 vs. 0.96 MoM) were recorded in the high-risk group, although the differences did not reach statistical significance (P = 0.19 and 0.40, respectively). After log-transformation there were no significant correlations between mean UtA-PI and NT and between mean UtA-PI and beta-hCG. There was a significant negative linear correlation between mean UtA-PI and PAPP-A (r

  11. Application of Neural Networks for classification of Patau, Edwards, Down, Turner and Klinefelter Syndrome based on first trimester maternal serum screening data, ultrasonographic findings and patient demographics.

    Science.gov (United States)

    Catic, Aida; Gurbeta, Lejla; Kurtovic-Kozaric, Amina; Mehmedbasic, Senad; Badnjevic, Almir

    2018-02-13

    The usage of Artificial Neural Networks (ANNs) for genome-enabled classifications and establishing genome-phenotype correlations have been investigated more extensively over the past few years. The reason for this is that ANNs are good approximates of complex functions, so classification can be performed without the need for explicitly defined input-output model. This engineering tool can be applied for optimization of existing methods for disease/syndrome classification. Cytogenetic and molecular analyses are the most frequent tests used in prenatal diagnostic for the early detection of Turner, Klinefelter, Patau, Edwards and Down syndrome. These procedures can be lengthy, repetitive; and often employ invasive techniques so a robust automated method for classifying and reporting prenatal diagnostics would greatly help the clinicians with their routine work. The database consisted of data collected from 2500 pregnant woman that came to the Institute of Gynecology, Infertility and Perinatology "Mehmedbasic" for routine antenatal care between January 2000 and December 2016. During first trimester all women were subject to screening test where values of maternal serum pregnancy-associated plasma protein A (PAPP-A) and free beta human chorionic gonadotropin (β-hCG) were measured. Also, fetal nuchal translucency thickness and the presence or absence of the nasal bone was observed using ultrasound. The architectures of linear feedforward and feedback neural networks were investigated for various training data distributions and number of neurons in hidden layer. Feedback neural network architecture out performed feedforward neural network architecture in predictive ability for all five aneuploidy prenatal syndrome classes. Feedforward neural network with 15 neurons in hidden layer achieved classification sensitivity of 92.00%. Classification sensitivity of feedback (Elman's) neural network was 99.00%. Average accuracy of feedforward neural network was 89.6% and for

  12. First-trimester screening for trisomies 18 and 13, triploidy and Turner syndrome by detailed early anomaly scan.

    Science.gov (United States)

    Wagner, P; Sonek, J; Hoopmann, M; Abele, H; Kagan, K O

    2016-10-01

    To examine the performance of first-trimester ultrasound screening for trisomies 18 and 13, triploidy and Turner syndrome based on fetal nuchal translucency thickness (NT), additional fetal ultrasound markers including anatomy of the nasal bone (NB), blood flow across the tricuspid valve (TV) and through the ductus venosus (DV) and a detailed fetal anomaly scan at 11-13 weeks' gestation. This was a retrospective case-matched study involving pregnant women at 11-13 weeks' gestation. The study population consisted of fetuses with trisomy 18, trisomy 13, triploidy or Turner syndrome. For each fetus with an abnormal karyotype, 50 randomly selected euploid fetuses were added to the study population. In all cases, the crown-rump length and NT were measured. In addition NB, TV flow and DV flow were examined. The summed risk for trisomies 21, 18 and 13 was computed based on: first, maternal age (MA); second, MA and fetal NT; third, MA, NT and one of the markers NB, TV flow or DV flow; fourth, MA, NT and all these markers combined; fifth, MA, NT and fetal anomalies; and, finally, MA, NT, all markers and fetal anomalies. The study population consisted of 4550 euploid and 91 aneuploid fetuses. Median NT was 1.8 mm in euploid fetuses and 4.8, 6.8, 1.8 and 10.0 mm in fetuses with trisomy 18, trisomy 13, triploidy and Turner syndrome, respectively. The NB, TV flow and DV flow were abnormal in 48 (1.1%), 34 (0.7%) and 99 (2.2%) euploid fetuses, respectively, and in 42 (46.2%), 31 (34.1%) and 62 (68.1%) aneuploid fetuses, respectively. At least one defect was found in 60 (1.3%) euploid and in 76 (83.5%) aneuploid fetuses. For a false-positive rate of 3%, the detection rate for screening based on MA and fetal NT was 75.8%. It increased to 84.6-86.8% when including one of the additional ultrasound markers and it was 90.1% when all three markers were included. When screening was based on MA, fetal NT and a detailed anomaly scan, the detection rate was 94.5% and increased to 95

  13. Rastreio para anomalias cromossômicas no primeiro trimestre da gestação First-trimester screening for chromosomal abnormalities

    Directory of Open Access Journals (Sweden)

    Kipros Herodotou Nicolaides

    2007-12-01

    Full Text Available Um efetivo rastreio para anomalias cromossômicas pode ser realizado no primeiro trimestre da gestação. A associação entre a transluscência nucal (TN e as concentrações séricas maternas da fração beta-livre da gonadotrofina coriônica humana e da proteína plasmática-A associada à gestação pode identificar 90% dos fetos com trissomia do cromossomo 21 e outras anomalias cromossômicas, com uma taxa de falso-positivo de 5%. Esses números são superiores aos obtidos pelo rastreio utilizando-se apenas a idade materna (30% ou o rastreio bioquímico materno, no segundo trimestre da gestação (65%. Um rastreio mais eficaz, no primeiro trimestre, pode ser atingido por meio de uma avaliação ecográfica em dois tempos, dividindo-se as pacientes em grupos de alto, intermediário e baixo risco. No grupo de alto risco, o diagnóstico invasivo estaria indicado, ao contrário do grupo de baixo risco, no qual a presença de uma anomalia seria pouco provável. No grupo de risco intermediário (risco de 1 em 101 a 1 em 1.000, seria oferecida uma segunda avaliação ecográfica, para posicionar a paciente no grupo de alto ou baixo risco (presença/ausência do osso nasal ou presença/ausência da regurgitação tricúspide ou presença/ausência de alteração do fluxo sangüíneo no ducto venoso. A biópsia de vilo corial estaria indicada quando, após a realização da segunda abordagem, o risco ajustado da paciente se tornasse maior ou igual a 1 em 100. Essa segunda abordagem ecográfica deveria ser realizada por pessoal treinado, e os seus resultados deveriam ser constantemente avaliados, como um controle de qualidade. Esse processo foi estabelecido pela Fetal Medicine Foudation e aceito internacionalmente.Screening for major chromosomal abnormalities can be provided in the first trimester of pregnancy. Screening by a combination of fetal nuchal translucency and maternal serum free human chorionic gonadotropin and pregnancy-associated plasma

  14. Organic molecules in translucent interstellar clouds.

    Science.gov (United States)

    Krełowski, Jacek

    2014-09-01

    Absorption spectra of translucent interstellar clouds contain many known molecular bands of CN, CH+, CH, OH, OH(+), NH, C2 and C3. Moreover, one can observe more than 400 unidentified absorption features, known as diffuse interstellar bands (DIBs), commonly believed to be carried by complex, carbon-bearing molecules. DIBs have been observed in extragalactic sources as well. High S/N spectra allow to determine precisely the corresponding column densities of the identified molecules, rotational temperatures which differ significantly from object to object in cases of centrosymmetric molecular species, and even the (12)C/(13)C abundance ratio. Despite many laboratory based studies of possible DIB carriers, it has not been possible to unambiguously link these bands to specific species. An identification of DIBs would substantially contribute to our understanding of chemical processes in the diffuse interstellar medium. The presence of substructures inside DIB profiles supports the idea that DIBs are very likely features of gas phase molecules. So far only three out of more than 400 DIBs have been linked to specific molecules but none of these links was confirmed beyond doubt. A DIB identification clearly requires a close cooperation between observers and experimentalists. The review presents the state-of-the-art of the investigations of the chemistry of interstellar translucent clouds i.e. how far our observations are sufficient to allow some hints concerning the chemistry of, the most common in the Galaxy, translucent interstellar clouds, likely situated quite far from the sources of radiation (stars).

  15. Prenatal diagnosis of spina bifida: from intracranial translucency to intrauterine surgery.

    Science.gov (United States)

    Sepulveda, Waldo; Wong, Amy E; Sepulveda, Francisco; Alcalde, Juan L; Devoto, Juan C; Otayza, Felipe

    2017-07-01

    Accurate and timely prenatal diagnosis of spina bifida (SB) is a major goal of modern antenatal care. Prenatal screening for open SB should be first performed at the time of routine first-trimester ultrasound by examining the posterior fossa for obliteration or non-visualization of the fourth ventricle ("intracranial translucency") and cisterna magna. The second step of screening is the second-trimester anatomy scan, at which time the features of the Chiari type II malformation should be looked for, including ventriculomegaly, scalloping of the frontal bones ("lemon" sign), and backward and caudal displacement of the cerebellar vermis with obliteration of the cisterna magna ("banana" sign). In cases with positive findings, evaluation must include a focused examination of the spine for defects. In cases of closed SB and SB occulta, the cranial and posterior fossa features will not be present as they are not associated with leaking of spinal fluid and resultant hindbrain herniation, highlighting the fact that the spine should be examined thoroughly whenever possible during the second-trimester scan. In tertiary fetal medicine centers, two-dimensional and three-dimensional ultrasound allows an accurate determination of the location, type, extent, and upper level of the spinal defect as well as the presence of associated anomalies. Fetal magnetic resonance imaging should be restricted to candidates for intrauterine surgery as part of the preoperative protocol.

  16. Relationship between Color and Translucency of Multishaded Dental Composite Resins

    Directory of Open Access Journals (Sweden)

    Homan Naeimi Akbar

    2012-01-01

    Full Text Available The aim of the present study was to compare the translucency of different shades of two highly aesthetic multilayered restorative composite resins. In total nine shades from Esthet.X and ten shades from Filtek Supreme composite resins were chosen. Discs of each shade were prepared (N=3 and light-cured. Total and diffuse transmittance values for each sample were measured. Statistical analysis showed that the opaque dentine shades of both composites were the least translucent and the enamel shades had the highest translucency. There was a significant decrease in translucency from A2 to C2 of regular body shades and also from A4 to C4 of opaque dentine shades of Esthet.X composite resin. Grey enamel shade had a significantly higher diffuse translucency compared to clear and yellow enamel shades. There was a significant decrease in translucency from A2B to D2B and also in diffuse translucency from A4D to C6D shades of Filtek Supreme composite resin. It can be concluded that the color of the composite resins tested in this study had a significant effect on their translucency. Information on the translucency of different shades of composite resins can be very useful for the clinicians in achieving optimal esthetic restorative outcome.

  17. Human perception of dental porcelain translucency correlated to spectrophotometric measurements.

    Science.gov (United States)

    Liu, Min-Chieh; Aquilino, Steven A; Lund, Peter S; Vargas, Marcos A; Diaz-Arnold, Ana M; Gratton, David G; Qian, Fang

    2010-04-01

    This study evaluated the relationship between instrumental measurements and subjective visual assessment of differences in dental porcelain translucency. Unshaded feldspathic porcelain was used with controlled amounts of tin oxide to create two groups of 12-mm diameter disks with incremental changes in opacity. Contrast ratio (CR = Yb/Yw) was determined with a spectrophotometer, and used as a measure of porcelain translucency (Group A = 0.20 to 0.40; Group B = 0.6-0.8). Within each group, there were 14 specimens with 11 CRs. Three observer groups (first year dental students, residents, faculty with >10 years of shade matching experience) were recruited to assess the translucency between porcelain disks under two lighting conditions (reflected light, transmitted light). Each subject's ability to distinguish between specimens of differing translucency was determined. Descriptive statistics and three-way ANOVA followed by a post-hoc Tukey-Kramer test were used to evaluate the translucency perception threshold (TPT) of subjects (alpha= 0.05). The overall mean TPT (DeltaC) was 0.07, while 50% of the subjects could perceive a 0.06 CR difference between porcelain specimens. Three-way ANOVA revealed a significant difference in translucency perception among the observer groups (p or =10 years) significantly improved the ability to perceive differences in translucency; however, neither the viewing condition nor porcelain opacity affected the perceived translucency threshold.

  18. Effect of hydrothermal treatment on light transmission of translucent zirconias.

    Science.gov (United States)

    Putra, Armand; Chung, Kwok-Hung; Flinn, Brian D; Kuykendall, Tuesday; Zheng, Cheng; Harada, Kosuke; Raigrodski, Ariel J

    2017-09-01

    Studies of the light transmission of translucent zirconias after hydrothermal treatment are limited. The purpose of this in vitro study was to evaluate the effect of hydrothermal treatment on the light transmission of translucent zirconias for monolithic restorations. Four commercially available zirconia products, BruxZir Anterior Solid Zirconia (BruxAnt, BA), Lava Plus High Translucency (LPHT), Katana Zirconia Super Translucent (KST), and Katana Zirconia Ultra Translucent (KUT) were assessed and 1 type of lithium disilicate, e.max Press LT (LDLT) was used as a control. Plate specimens, 20×20×1 mm (n=80) for the translucency assessment were sectioned from postsintered zirconia bulk materials and ground with a #400-grit diamond wheel and coolant. The specimens were placed under hydrothermal conditions of 134°C at 0.2 MPa (n=5 per group at 0, 5, 50, and 100 hours). Percentage of total transmittance of light (T t %) of each specimen was measured using a spectrophotometer with an integrating sphere. X-ray diffraction analyses were used to measure tetragonal-monoclinic phase transformation. Surfaces were examined by scanning electron microscopy and energy dispersive spectrometry. Data were analyzed using 2-way ANOVA followed by the Tukey test (α=.05). The T t % ranged from 6.5% to 28.3%. Group LDLT obtained significantly higher transmittance than other tested groups, whereas groups KST and KUT had significantly higher T t % than groups BA and LPHT (Phydrothermal treatment for all tested translucent zirconias and a lithium disilicate glass-ceramic control. Hydrothermal treatment had minimal effects on the translucency of translucent zirconias. The tetragonal-monoclinic phase transformation rate of translucent zirconias was found to be low, except in group LPHT. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  19. IVF culture medium affects human intrauterine growth as early as the second trimester of pregnancy.

    Science.gov (United States)

    Nelissen, Ewka C M; Van Montfoort, Aafke P A; Smits, Luc J M; Menheere, Paul P C A; Evers, Johannes L H; Coonen, Edith; Derhaag, Josien G; Peeters, Louis L; Coumans, Audrey B; Dumoulin, John C M

    2013-08-01

    When does a difference in human intrauterine growth of singletons conceived after IVF and embryo culture in two different culture media appear? Differences in fetal development after culture of embryos in one of two IVF media were apparent as early as the second trimester of pregnancy. Abnormal fetal growth patterns are a major risk factor for the development of chronic diseases in adult life. Previously, we have shown that the medium used for culturing embryos during the first few days after fertilization significantly affects the birthweight of the resulting human singletons. The exact onset of this growth difference was unknown. In this retrospective cohort study, all 294 singleton live births after fresh embryo transfer in the period July 2003 to December 2006 were included. These embryos originated from IVF treatments that were part of a previously described clinical trial. Embryos were allocated to culture in either Vitrolife or Cook commercially available sequential culture media. We analysed ultrasound examinations at 8 (n = 290), 12 (n = 83) and 20 weeks' (n = 206) gestation and used first-trimester serum markers [pregnancy-associated plasma protein-A (PAPP-A) and free β-hCG]. Differences between study groups were tested by the Student's t-test, χ(2) test or Fisher's exact test, and linear multivariable regression analysis to adjust for possible confounders (for example, parity, gestational age at the time of ultrasound and fetal gender). A total of 294 singleton pregnancies (Vitrolife group nVL = 168, Cook group: nC = 126) from 294 couples were included. At 8 weeks' gestation, there was no difference between crown-rump length-based and ovum retrieval-based gestational age (ΔGA) (nVL = 163, nC = 122, adjusted mean difference, -0.04 days, P = 0.84). A total of 83 women underwent first-trimester screening at 12 weeks' gestation (nVL = 45, nC = 38). ΔGA, nuchal translucency (multiples of median, MoM) and PAPP-A (MoM) did not differ between the study

  20. Diagnosis and management of cranial and caudal nuchal bursitis in four horses.

    Science.gov (United States)

    García-López, José M; Jenei, Thomas; Chope, Kate; Bubeck, Kirstin A

    2010-10-01

    4 horses with a history of neck pain, abnormal head carriage, and related inability to perform were examined. Cranial nuchal bursitis was diagnosed in 2 horses, and caudal nuchal bursitis was diagnosed in the other 2. All 4 horses had prominent swelling in the region between the frontal bone and temporal fossa (ie, the poll) and abnormal head carriage. Ultrasonographic examination revealed fluid distention and synovial thickening of the cranial or caudal nuchal bursa in all 4 horses. Ultrasonography-guided aspiration of the affected region was performed successfully in 3 horses. Radiography revealed bony remodeling and mineralization over the dorsal aspect of the atlas in 1 horse and a radiolucency at the axis in another. Nuclear scintigraphy revealed an increase in radioisotope uptake at the level of C2 in 1 horse. Although a septic process was considered among the differential diagnoses in all horses, a septic process could only be confirmed in 1 horse. All horses were refractory to conservative management consisting of intrabursal injection of anti-inflammatory medications. Bursoscopic debridement and lavage of the affected bursae resulted in resolution of the clinical signs in all horses, and they all returned to their intended use. Cranial and caudal nuchal bursitis, of nonseptic or septic origin, should be considered as a differential diagnosis in horses with head and neck pain. Horses undergoing surgical intervention consisting of nuchal bursoscopy have the opportunity to return to their original degree of exercise.

  1. Translucency and Strength of High-Translucency Monolithic Zirconium-Oxide Materials

    Science.gov (United States)

    2016-05-12

    Translucency parameter was calculated using a spectrophotometer (VITA Easyshade, Vident) that measured L*, a*, and b* values. To evaluate flexural...dentistry for many years. In the mid-1900’s, dental materials researchers began marketing and manufacturing metal -ceramic restorations which had...strength and accuracy due to the cast metal , but also provided esthetically pleasing results because of the ceramic (Shillingburg et al., 1997). For

  2. Optical Fibres in the Modeling of Translucent Concrete Blocks

    OpenAIRE

    M.N.V.Padma Bhushan, D.Johnson, Md. Afzal Basheer Pasha And Ms. K. Prasanthi

    2013-01-01

    Translucent concrete is a concrete based material with light-transmissive properties, obtained due to embedded light optical elements like Optical fibers in it. Light is conducted through the stone from one end to the other. This results into a certain light pattern on the other surface, depending on the fibre structure. Optical fibres transmit light so effectively that there is virtually no loss of light conducted through the fibres. Our paper deals with the modelling of such translucent or ...

  3. Second trimester abortions in India.

    Science.gov (United States)

    Dalvie, Suchitra S

    2008-05-01

    This article gives an overview of what is known about second trimester abortions in India, including the reasons why women seek abortions in the second trimester, the influence of abortion law and policy, surgical and medical methods used, both safe and unsafe, availability of services, requirements for second trimester service delivery, and barriers women experience in accessing second trimester services. Based on personal experiences and personal communications from other doctors since 1993, when I began working as an abortion provider, the practical realities of second trimester abortion and case histories of women seeking second trimester abortion are also described. Recommendations include expanding the cadre of service providers to non-allopathic clinicians and trained nurses, introducing second trimester medical abortion into the public health system, replacing ethacridine lactate with mifepristone-misoprostol, values clarification among providers to challenge stigma and poor treatment of women seeking second trimester abortion, and raising awareness that abortion is legal in the second trimester and is mostly not requested for reasons of sex selection.

  4. Translucent zirconia in the ceramic scenario for monolithic restorations: A flexural strength and translucency comparison test.

    Science.gov (United States)

    Carrabba, Michele; Keeling, Andrew J; Aziz, Aziz; Vichi, Alessandro; Fabian Fonzar, Riccardo; Wood, David; Ferrari, Marco

    2017-05-01

    To compare three different compositions of Yttria-Tetragonal Zirconia Polycrystal (Y-TZP) ceramic and a lithium disilicate ceramic in terms of flexural strength and translucency. Three zirconia materials of different composition and translucency, Aadva ST [ST], Aadva EI [EI] and Aadva NT [NT](GC Tech, Leuven, Belgium) were cut with a slow speed diamond saw into beams and tabs in order to obtain, after sintering, dimensions of 1.2×4.0×15.0mm and 15.0×15.0×1.0mm respectively. Blocks of IPS e.max CAD LT were cut and crystallized in the same shapes and dimensions and used as a reference group [LD]. Beams (n=15) were tested in a universal testing machine for three-point bending strength. Critical fracture load was recorded in N, flexural strength (σ in MPa), Weibull modulus (m) and Weibull characteristic strength (σ 0 in MPa) were then calculated. Tabs (n=10) were measured with a spectrophotometer equipped with an integrating sphere. Contrast Ratios were calculated as CR=Yb/Yw. SEM of thermally etched samples coupled with lineal line analysis (n=6) was used to measure the tested zirconia grain size. Data were statistically analyzed. Differences in translucency, flexural strength and grain size were found to be statistically significant. CR increased and flexural strength decreased in the following order ST(σ 1215±190MPa, CR 0.74±0.01)>EI(σ 983±182MPa, CR 0.69±0.01)>NT(σ 539±66MPa, CR 0.65±0.01)>LD (σ 377±39Mpa, CR 0.56±0.02). The average grain size was different for the three zirconia samples with NT(558±38nm)>ST(445±34nm)>EI(284±11nm). The zirconia composition heavily influenced both the flexural strength and the translucency. Different percentages of Yittria and Alumina result in new materials with intermediate properties in between the conventional zirconia and lithium disilicate. Clinical indications for Zirconia Aadva NT should be limited up to three-unit span bridges. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. A Comparison of Tensile Bond Strength Between Low Translucency and High Translucency Lithium Disilicate Ceramics Using Two Different Resin Cements

    Science.gov (United States)

    2015-06-01

    Computer animated design of a veneered dental restoration 2 Figure 2: Computer animated design of a cementable dental implant restoration using a...Hill, E. E. (2007). Dental cements for definitive luting: a review and practical clinical considerations. Dental Clinics of North America, 51(3), 643-58...A COMPARISON OF TENSILE BOND STRENGTH BETWEEN LOW TRANSLUCENCY AND HIGH TRANSLUCENCY LITHIUM DISILICATE CERAMICS USING TWO DIFFERENT RESIN CEMENTS

  6. Fluorescent nanodiamonds embedded in biocompatible translucent shells.

    Science.gov (United States)

    Rehor, Ivan; Slegerova, Jitka; Kucka, Jan; Proks, Vladimir; Petrakova, Vladimira; Adam, Marie-Pierre; Treussart, François; Turner, Stuart; Bals, Sara; Sacha, Pavel; Ledvina, Miroslav; Wen, Amy M; Steinmetz, Nicole F; Cigler, Petr

    2014-03-26

    High pressure high temperature (HPHT) nanodiamonds (NDs) represent extremely promising materials for construction of fluorescent nanoprobes and nanosensors. However, some properties of bare NDs limit their direct use in these applications: they precipitate in biological solutions, only a limited set of bio-orthogonal conjugation techniques is available and the accessible material is greatly polydisperse in shape. In this work, we encapsulate bright 30-nm fluorescent nanodiamonds (FNDs) in 10-20-nm thick translucent (i.e., not altering FND fluorescence) silica shells, yielding monodisperse near-spherical particles of mean diameter 66 nm. High yield modification of the shells with PEG chains stabilizes the particles in ionic solutions, making them applicable in biological environments. We further modify the opposite ends of PEG chains with fluorescent dyes or vectoring peptide using click chemistry. High conversion of this bio-orthogonal coupling yielded circa 2000 dye or peptide molecules on a single FND. We demonstrate the superior properties of these particles by in vitro interaction with human prostate cancer cells: while bare nanodiamonds strongly aggregate in the buffer and adsorb onto the cell membrane, the shell encapsulated NDs do not adsorb nonspecifically and they penetrate inside the cells. © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  7. Neuroimaging parameters in early open spina bifida detection. Further benefit in first trimester screening?

    Science.gov (United States)

    Iliescu, D; Comănescu, A; Antsaklis, P; Tudorache, Stefania; Ghiluşi, Mirela; Comănescu, Violeta; Paulescu, Daniela; Ceauşu, Iuliana; Antsaklis, A; Novac, Liliana; Cernea, N

    2011-01-01

    Morphological investigation of the central nervous system (CNS) in fetuses with positive markers for open spina bifida (OSB) detection, visualized by ultrasound during the first trimester of pregnancy. Data from fetuses that underwent routine first trimester ultrasound scan in our center during September 2007-March 2011 and presented abnormal aspects of the fourth ventricle, also referred as intracranial translucency (IT), provided the morphological support to evaluate CNS features. A neuro-histological study of posterior cerebral fossa illustrated anatomical features of the structures involved in the sonographic first trimester detection of neural tube defects. Abnormal IT aspects were found in OSB cases examined in the first trimester, but also in other severe cerebral abnormalities. Brain stem antero-posterior diameter (BS) and brain stem to occipital bone (BSOB) ratio may be more specific for OSB detection. Correlations between histological aspects of posterior brain fossa and ultrasound standard assessment have been made; highlighting the anatomical features involved by the new techniques developed for OSB early detection. Preliminary results show that modern sonographic protocols are capable to detect abnormalities in the morphometry of the posterior brain. First trimester fourth ventricle abnormalities should be followed by careful CNS evaluation because are likely to appear in OSB affected fetuses, but also in other CNS severe anomalies; in such cases, normal BS and BSOB ratio may serve as indirect argument for spine integrity, if specificity is confirmed in large series of fetuses.

  8. Prenatal diagnosis of Smith–Magenis syndrome in two fetuses with increased nuchal translucency, mild lateral ventriculomegaly, and congenital heart defects

    Directory of Open Access Journals (Sweden)

    Ting-Ying Lei

    2016-12-01

    Conclusion: The findings further confirm that increased NT is associated with genetic syndromes, and brain imaging is necessary for SMS fetuses. Both deletions encompass the SMS “critical region”, which includes many genes including RAI1. However, the precise gene(s responsible for the heart defects in SMS remain unclear; further efforts should be undertaken to understand the molecular basis of this syndrome.

  9. Prenatal diagnostics in TESA/PESA pregnancies in Denmark 1995-2007: a shift from invasive procedures to nuchal translucency examination

    DEFF Research Database (Denmark)

    Fedder, Jens; Erb, Karin; Humaidan, Peter

    2011-01-01

    Evidently, children born after intracytoplasmic sperm injection (ICSI) are at an increased risk of having sex chromosomal abnormalities. Here we evaluate the change in methods used for prenatal diagnostics in patients having ICSI with epididymal or testicular sperm from the introduction...

  10. Investigation into the Translucency of Tooth-Colored Restorative Materials

    Directory of Open Access Journals (Sweden)

    H. Torabzadeh

    2009-09-01

    Full Text Available Objective: The aim of this study was to investigate the translucency of resin-modified glass-ionomer cements (RMGIC and polyacid-modified composite resin (PCMR over a period of one year.Materials and Methods: The study was done on three RMGIC (Fuji II LC, Photac-Fil Aplicap and Vitremer and one PCMR (Dyract. A conventional GIC (Fuji Cap II and two composite resins (Tetric and Z 100 were used for comparison. Five discs approximately 5 mm in diameter and 1.5 mm thick were made from each material using a Perspex mould. The specimens were kept in distilled water at 37°C during the test period. The optical density/mm (inverse of translucency of each material was measured using a special photometric set up after preparation and after one week, six months, and one year.Means and standard deviations were calculated and subjected to Two-way ANOVA, Oneway ANOVA and Scheffe tests.Results: The results indicated that all of the materials, except Dyract, showed an increase of translucency over the test period. After one year, the conventional GIC was the least translucent material.Conclusion: The translucency of the resin-modified GICs and Dyract was equivalent to that of the composite resins Tetric and Z 100.

  11. DoubleFace: Adjustable translucent system to improve thermal comfort

    Directory of Open Access Journals (Sweden)

    Michela Turrin

    2014-11-01

    Full Text Available The DoubleFace project aims at developing a new product that passively improves thermal comfort of indoor and semi-indoor spaces by means of lightweight materials for latent heat storage, while simultaneously allowing daylight to pass through as much as possible. Specifically, the project aims at designing and prototyping an adjustable translucent modular system featuring thermal insulation and thermal absorption in a calibrated manner, which is adjustable according to different heat loads during summer- and wintertime. The output consists of a proof of concept, a series of performance simulations and measurement and a prototype of an adjustable thermal mass system based on lightweight and translucent materials: phase-changing materials (PCM for latent heat storage and translucent aerogel particles for thermal insulation.

  12. The Gas-Grain Chemistry of Galactic Translucent Clouds

    Science.gov (United States)

    Maffucci, Dominique M.; Herbst, Eric

    2016-01-01

    We employ a combination of traditional and modified rate equation approaches to simulate the time-dependent gas-grain chemistry that pertains to molecular species observed in absorption in Galactic translucent clouds towards Sgr B2(N). We solve the kinetic rate laws over a range of relevant physical conditions (gas and grain temperatures, particle density, visual extinction, cosmic ray ionization rate) characteristic of translucent clouds by implementing a new grid module that allows for parallelization of the astrochemical simulations. Gas-phase and grain-surface synthetic pathways, chemical timescales, and associated physical sensitivities are discussed for selected classes of species including the cyanopolyynes, complex cyanides, and simple aldehydes.

  13. Prenatal Care: Second Trimester Visits

    Science.gov (United States)

    ... Pregnancy week by week During the second trimester, prenatal care includes routine lab tests and measurements of your ... too. By Mayo Clinic Staff The goal of prenatal care is to ensure that you and your baby ...

  14. Prenatal Care: Third Trimester Visits

    Science.gov (United States)

    ... Pregnancy week by week During the third trimester, prenatal care might include vaginal exams to check the baby's position. By Mayo Clinic Staff Prenatal care is an important part of a healthy pregnancy, ...

  15. Effect of different semimonolithic designs on fracture resistance and fracture mode of translucent and high-translucent zirconia crowns

    Science.gov (United States)

    Bakitian, Fahad; Seweryniak, Przemek; Papia, Evaggelia; Larsson, Christel; Vult von Steyern, Per

    2018-01-01

    Purpose The aim of this study was to describe different designs of semimonolithic crowns made of translucent and high-translucent zirconia materials and to evaluate the effect on fracture resistance and fracture mode. Methods One hundred crowns with different designs were produced and divided into five groups (n=20): monolithic (M), partially veneered monolithic (semimonolithic) with 0.3 mm buccal veneer (SM0.3), semimonolithic with 0.5 mm buccal veneer (SM0.5), semimonolithic with 0.5 mm buccal veneer supported by wave design (SMW), and semimonolithic with 0.5 mm buccal veneer supported by occlusal cap design (SMC). Each group was divided into two subgroups (n=10) according to the materials used, translucent and high-translucent zirconia. All crowns underwent artificial aging before loading until fracture. Fracture mode analysis was performed. Fracture loads and fracture modes were analyzed using two-way ANOVA and Fisher’s exact probability tests (P≤0.05). Results SM0.3 design showed highest fracture loads with no significant difference compared to M and SMW designs (P>0.05). SM0.5 design showed lower fracture loads compared to SMW and SWC designs. Crowns made of translucent zirconia showed higher fracture loads compared to those made of high-translucent zirconia. M, SM0.3, and all but one of the SMC crowns showed complete fractures with significant differences in fracture mode compared to SMW and SM0.5 crowns with cohesive veneer fractures (P≤0.05). Conclusion Translucent and high-translucent zirconia crowns might be used in combination with 0.3 mm microcoating porcelain layer with semimonolithic design to enhance the esthetic properties of restorations without significantly decreasing fracture resistance of the crowns. If 0.5 mm porcelain layer is needed for a semimonolithic crown, wave design or cap design might be used to increase fracture resistance. In both cases, fracture resistance gained is likely to be clinically sufficient as the registered

  16. Effect of different semimonolithic designs on fracture resistance and fracture mode of translucent and high-translucent zirconia crowns

    Directory of Open Access Journals (Sweden)

    Bakitian F

    2018-03-01

    Full Text Available Fahad Bakitian,1,2 Przemek Seweryniak,3 Evaggelia Papia,1 Christel Larsson,1 Per Vult von Steyern1 1Department of Materials Science and Technology, Faculty of Odontology, Malmö University, Malmö, Sweden; 2Department of Restorative Dentistry, Faculty of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia; 3Commercial Dental Laboratory, Malmö, Sweden Purpose: The aim of this study was to describe different designs of semimonolithic crowns made of translucent and high-translucent zirconia materials and to evaluate the effect on fracture resistance and fracture mode.Methods: One hundred crowns with different designs were produced and divided into five groups (n=20: monolithic (M, partially veneered monolithic (semimonolithic with 0.3 mm buccal veneer (SM0.3, semimonolithic with 0.5 mm buccal veneer (SM0.5, semimonolithic with 0.5 mm buccal veneer supported by wave design (SMW, and semimonolithic with 0.5 mm buccal veneer supported by occlusal cap design (SMC. Each group was divided into two subgroups (n=10 according to the materials used, translucent and high-translucent zirconia. All crowns underwent artificial aging before loading until fracture. Fracture mode analysis was performed. Fracture loads and fracture modes were analyzed using two-way ANOVA and Fisher’s exact probability tests (P≤0.05.Results: SM0.3 design showed highest fracture loads with no significant difference compared to M and SMW designs (P>0.05. SM0.5 design showed lower fracture loads compared to SMW and SWC designs. Crowns made of translucent zirconia showed higher fracture loads compared to those made of high-translucent zirconia. M, SM0.3, and all but one of the SMC crowns showed complete fractures with significant differences in fracture mode compared to SMW and SM0.5 crowns with cohesive veneer fractures (P≤0.05.Conclusion: Translucent and high-translucent zirconia crowns might be used in combination with 0.3 mm microcoating porcelain layer with

  17. The Translucency Effect of Different Colored Resin Cements used ...

    African Journals Online (AJOL)

    Purpose: The purpose of this study was to evaluate the effect of the different color of resin cements and zirconia cores on the translucency parameter (TP) of the restoration that simulates the implant‑supported fixed prosthesis using titanium base on the bottom. Materials and Methods: Zirconia core plates (Zr‑Zahn) were ...

  18. ATOMIC AND MOLECULAR CARBON AS A TRACER OF TRANSLUCENT CLOUDS

    International Nuclear Information System (INIS)

    Burgh, Eric B.; France, Kevin; Jenkins, Edward B.

    2010-01-01

    Using archival, high-resolution far-ultraviolet Hubble Space Telescope/Space Telescope Imaging Spectrograph spectra of 34 Galactic O and B stars, we measure C I column densities and compare them with measurements from the literature of CO and H 2 with regard to understanding the presence of translucent clouds along the line of sight. We find that the CO/H 2 and CO/C I ratios provide good discriminators for the presence of translucent material, and both increase as a function of molecular fraction, f N = 2N(H 2 )/N(H). We suggest that sightlines with values below CO/H 2 ∼10 -6 and CO/C I ∼1 contain mostly diffuse molecular clouds, while those with values above sample clouds in the transition region between diffuse and dark. These discriminating values are also consistent with the change in slope of the CO versus H 2 correlation near the column density at which CO shielding becomes important, as evidenced by the change in photochemistry regime studied by Sheffer et al. Based on the lack of correlation of the presence of translucent material with traditional measures of extinction, we recommend defining 'translucent clouds' based on the molecular content rather than line-of-sight extinction properties.

  19. The Translucency Effect of Different Colored Resin Cements used ...

    African Journals Online (AJOL)

    2018-01-30

    Jan 30, 2018 ... [32] studied the optical effect of composite resins on ceramic crowns and noted that there are no industrial standards for resin shade classification. The results of the present study show that cements of the same shade in different systems exhibit different color parameters. In terms of opacity or translucency, ...

  20. Hyperforin accumulates in the translucent glands of Hypericum perforatum

    DEFF Research Database (Denmark)

    Soelberg, Jens; Jørgensen, Lise Bolt; Jäger, Anna K

    2007-01-01

    BACKGROUND AND AIMS: Hypericum perforatum contains the therapeutically important compounds hypericin and hyperforin. Hypericin is known to accumulate in the dark glands. This investigation aimed to determine the accumulation site of hyperforin. METHODS: Dark and translucent glands as well as non-...

  1. The Translucency Effect of Different Colored Resin Cements used ...

    African Journals Online (AJOL)

    2018-01-30

    Jan 30, 2018 ... Purpose: The purpose of this study was to evaluate the effect of the different color of resin cements and zirconia cores on the translucency parameter (TP) of the restoration that simulates the implant‑supported fixed prosthesis using titanium base on the bottom. Materials and Methods: Zirconia core plates ...

  2. Author Details

    African Journals Online (AJOL)

    Nicolaou, E. Vol 98, No 4 (2008): - Articles Nuchal translucency as a method of first-trimester screening for aneuploidy. Abstract PDF · Vol 105, No 10 (2015) - Articles Case Report: Delayed presentation and diagnosis of metastatic hepatocellular carcinoma in pregnancy. Abstract PDF · Vol 95, No 9 (2005) - Articles Cervical ...

  3. Your Baby's Development: The First Trimester

    Science.gov (United States)

    ... how your baby develops during the first trimester. Path to well being Pregnancy begins when a man’s ... You’ll probably feel them starting in the middle of the second trimester. After the embryonic stage, ...

  4. Measurement of Colour on Translucent Material Viewed by Reflection

    Directory of Open Access Journals (Sweden)

    Aditya Sole

    2007-11-01

    Full Text Available In this paper a measurement technique is developed to measure colour printed on translucent media with reflection mode geometry with a backing material. A number of paper backing materials along with PTFE plaque tiles of 10 mm and 6 mm thickness are investigated for conformation with ISO/CD 13655 (2006 and CGATS (2001 standards for backing materials. A measurement procedure is developed using these backing materials to make measurements relative to perfect diffuser. A model is also developed to predict CIE XYZ tri-stimulus values of a colour patch to be printed on paper to match with the same colour patch printed on translucent substrate viewed by reflection with a GMG double backing proofing paper. This model is then evaluated psychophysically using a halftone print. Categorical judgement technique is used to collect visual data.

  5. First Trimester Listeria monocytogenes Septicemia

    NARCIS (Netherlands)

    Goddijn, M.; Schipper, H. G.; Spanjaard, L.; Wolf, H.

    1997-01-01

    Background: Little is known about fetal outcome after Listeria monocytogenes septicemia in the first trimester of pregnancy.Case: A primigravida with L. monocytogenes septicemia at 9 weeks gestation was treated with amoxicillin. At 40 weeks gestation a healthy female infant was born.Conclusion: This

  6. Evaluation of translucency of monolithic zirconia and framework zirconia materials

    OpenAIRE

    Tuncel, ?lkin; Turp, I??l; ???mez, Asl?han

    2016-01-01

    PURPOSE The opacity of zirconia is an esthetic disadvantage that hinders achieving natural and shade-matched restorations. The aim of this study was to evaluate the translucency of non-colored and colored framework zirconia and monolithic zirconia. MATERIALS AND METHODS The three groups tested were: non-colored framework zirconia, colored framework zirconia with the A3 shade according to Vita Classic Scale, and monolithic zirconia (n=5). The specimens were fabricated in the dimensions of 15?1...

  7. Homology of the enigmatic nuchal bone reveals novel reorganization of the shoulder girdle in the evolution of the turtle shell.

    Science.gov (United States)

    Lyson, Tyler R; Bhullar, Bhart-Anjan S; Bever, Gabe S; Joyce, Walter G; de Queiroz, Kevin; Abzhanov, Arhat; Gauthier, Jacques A

    2013-01-01

    The turtle shell represents a unique modification of the ancestral tetrapod body plan. The homologies of its approximately 50 bones have been the subject of debate for more than 200 years. Although most of those homologies are now firmly established, the evolutionary origin of the dorsal median nuchal bone of the carapace remains unresolved. We propose a novel hypothesis in which the nuchal is derived from the paired, laterally positioned cleithra-dorsal elements of the ancestral tetrapod pectoral girdle that are otherwise retained among extant tetrapods only in frogs. This hypothesis is supported by origin of the nuchal as paired, mesenchymal condensations likely derived from the neural crest followed by a unique two-stage pattern of ossification. Further support is drawn from the establishment of the nuchal as part of a highly conserved "muscle scaffold" wherein the cleithrum (and its evolutionary derivatives) serves as the origin of the Musculus trapezius. Identification of the nuchal as fused cleithra is congruent with its general spatial relationships to other elements of the shoulder girdle in the adult morphology of extant turtles, and it is further supported by patterns of connectivity and transformations documented by critical fossils from the turtle stem group. The cleithral derivation of the nuchal implies an anatomical reorganization of the pectoral girdle in which the dermal portion of the girdle was transformed from a continuous lateral-ventral arc into separate dorsal and ventral components. This transformation involved the reduction and eventual loss of the scapular rami of the clavicles along with the dorsal and superficial migration of the cleithra, which then fused with one another and became incorporated into the carapace. © 2013 Wiley Periodicals, Inc.

  8. Correlation between ceramics translucency and polymerization efficiency through ceramics.

    Science.gov (United States)

    Ilie, Nicoleta; Hickel, Reinhard

    2008-07-01

    The aim of this study was to analyse the effects of curing with a high intensity curing unit for different exposure times, for different ceramic types, thicknesses and corresponding different ceramic translucencies. The relationship between ceramic translucency and hardness, as well as the critical translucency value for sufficient curing were also determined. All these effects were expressed in terms of Vickers hardness measured with an automatic micro hardness indenter on thin luting composite films (Variolink II), stored for 24h in distilled water at 37 degrees C. Two preliminary studies determined the time necessary to achieve maximum hardness in the luting composite, with and without an additional chemical catalyst. The main study aimed to estimate the effect on luting composite hardness, without an additional chemical catalyst, of the following parameters: curing time (5, 10 and 15s), ceramic thickness (0.5, 1, 2 and 3mm), ceramic type (two leucite-reinforced and two lithium disilicate glass-ceramics) and ceramic translucency (TP), measured using a reflection spectrophotometer as a function of wavelength. The minimum curing time necessary to achieve maximum hardness in the luting composite was 15s for both groups, with and without an additional chemical catalyst. However, dual curing caused a hardness enhancement of ca. 50%. The two leucite-reinforced glass-ceramics did not reduced the hardness of the luting composite up to a ceramic thickness of 2mm, whereas the more dense lithium disilicate glass-ceramics had already caused this effect at a thickness of 1mm. ANOVA analyses revealed that the greatest effect on the luting composite hardness resulted from the curing time (eta square=0.62) followed by translucency (eta square=0.32 TP650 nm and 0.28 for TP470 nm), ceramic type (eta square=0.17) and ceramic thickness (eta square=0.03). High-power curing units are not able to consistently reduce the exposure time. In both systems, at least 15s were necessary to

  9. Ceramic materials for porcelain veneers: part II. Effect of material, shade, and thickness on translucency.

    Science.gov (United States)

    Barizon, Karine T L; Bergeron, Cathia; Vargas, Marcos A; Qian, Fang; Cobb, Deborah S; Gratton, David G; Geraldeli, Saulo

    2014-10-01

    Information regarding the differences in translucency among new ceramic systems is lacking. The purpose of this study was to compare the relative translucency of the different types of ceramic systems indicated for porcelain veneers and to evaluate the effect of shade and thickness on translucency. Disk specimens 13 mm in diameter and 0.7-mm thick were fabricated for the following 9 materials (n=5): VITA VM9, IPS Empress Esthetic, VITA PM9, Vitablocks Mark II, Kavo Everest G-Blank, IPS Empress CAD, IPS e.max CAD, IPS e.maxPress, and Lava Zirconia. VITA VM9 served as the positive control and Lava as the negative control. The disks were fabricated with the shade that corresponds to A1. For IPS e.maxPress, additional disks were made with different shades (BL2, BL4, A1, B1, O1, O2, V1, V2, V3), thickness (0.3 mm), and translucencies (high translucency, low translucency). Color coordinates (CIE L∗ a∗ b∗) were measured with a tristimulus colorimeter. The translucency parameter was calculated from the color difference of the material on a black versus a white background. One-way ANOVA, the post hoc Tukey honestly significant difference, and the Ryan-Einot-Gabriel-Welsch multiple range tests were used to analyze the data (α=.05). Statistically significant differences in the translucency parameter were found among porcelains (PPM9, Empress Esthetic>Empress CAD>Mark II, Everest, e.max CAD>e.max Press>Lava. Significant differences also were noted when different shades and thickness were compared (Pceramic systems designed for porcelain veneers present varying degrees of translucency. The thickness and shade of lithium disilicate ceramic affect its translucency. Shade affects translucency parameter less than thickness. Copyright © 2014 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  10. Analysis of translucency of skin by volume reflection for color formulation of facial prostheses

    NARCIS (Netherlands)

    Korfage, Anke; Borsboom, Peter C. F.; Dijkstra, Pieter U.; van Oort, Robert P.

    2009-01-01

    Purpose: A facial prosthesis demands a good visual match with the adjacent skin. Skin color and translucency must be mimicked by the prosthesis. Translucency can be defined as allowing the passage of light, yet diffusing it so as not to render the bodies beyond clearly visible, therefore being

  11. PerPos: a Translucent Positioning Middleware Supporting Adaptation of Internal Positioning Processes

    DEFF Research Database (Denmark)

    Jensen, Jakob Langdal; Schougaard, Kari Rye; Kjærgaard, Mikkel Baun

    2010-01-01

    process. To address this problem this paper proposes a positioning middleware named PerPos that is translucent and adaptable, i.e., it supports both high- and low-level interaction. The PerPos middleware provides translucency with respect to the positioning process and allows programmatic definition...

  12. Modelling RGB colour aspects and translucency of fresh-cut tomatoes

    NARCIS (Netherlands)

    Moreira Lana, M.; Tijskens, L.M.M.; Kooten, van O.

    2006-01-01

    Translucency is one of the major problems in fresh-cut fruit. This phenomenon seriously limits the use of fruit by the fresh-cut industries. Techniques for measuring translucency in this kind of product are not readily available. As a consequence, the processes that are important in the development

  13. Translucent Players: Explaining Cooperative Behavior in Social Dilemmas

    Directory of Open Access Journals (Sweden)

    Valerio Capraro

    2016-06-01

    Full Text Available In the last few decades, numerous experiments have shown that humans do not always behave so as to maximize their material payoff. Cooperative behavior when non-cooperation is a dominant strategy (with respect to the material payoffs is particularly puzzling. Here we propose a novel approach to explain cooperation, assuming what Halpern and Pass call translucent players. Typically, players are assumed to be opaque, in the sense that a deviation by one player in a normal-form game does not affect the strategies used by other players. But a player may believe that if he switches from one strategy to another, the fact that he chooses to switch may be visible to the other players. For example, if he chooses to defect in Prisoner's Dilemma, the other player may sense his guilt. We show that by assuming translucent players, we can recover many of the regularities observed in human behavior in well-studied games such as Prisoner's Dilemma, Traveler's Dilemma, Bertrand Competition, and the Public Goods game.

  14. First Trimester Ultrasound Screening for Congenital Abnormalities ...

    African Journals Online (AJOL)

    approach used, especially with the introduction of first trimester ultrasound as a reliable screening method. Objective: To give a comprehensive review of the basis for first trimester ultrasound screening for congenital abnormalities, it's utilization in the prenatal screening for chromosomal, structural and genetic abnormalities ...

  15. First trimester bleeding and maternal cardiovascular morbidity

    DEFF Research Database (Denmark)

    Lykke, Jacob A; Langhoff-Roos, Jens

    2012-01-01

    First trimester bleeding without miscarriage is a risk factor for complications later in the pregnancy, such as preterm delivery. Also, first trimester miscarriage has been linked to subsequent maternal ischemic heart disease. We investigated the link between maternal cardiovascular disease prior...

  16. Unmasking translucent protein particles by improved micro-flow imaging™ algorithms.

    Science.gov (United States)

    Pedersen, Jesper Søndergaard; Persson, Malin

    2014-01-01

    Micro-flow imaging (MFI(™) ) is an increasingly important technique for the characterization of subvisible particles during the development of biopharmaceutical products. Protein particles are highly variable in size, appearance, and translucency posing challenges to optical detection techniques. We have developed a set of standard statistical tests applicable for routine evaluation of MFI™ particle dataset quality. The tests evaluate the spatial randomness of particles using nearest neighbor and quadrat analysis. Using case studies of stressed antibody samples, we demonstrate how the tests uncover fragmentation artifacts and uneven detector sensitivity for translucent particles. To improve the detection of translucent particles, a new local pixel intensity variance particle detection algorithm has been developed. The improved algorithm significantly decreases fragmentation artifacts, and also increases sensitivity toward translucent particles in general. Our results highlight current limitations and the potential for improvements in the optical detection techniques for subvisible protein aggregates. © 2013 Wiley Periodicals, Inc. and the American Pharmacists Association.

  17. Prenatal care in your second trimester

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000557.htm Prenatal care in your second trimester To use the sharing ... Gregory KD, Ramos DE, Jauniaux ERM. Preconception and prenatal care. In: Gabbe SG, Niebyl JR, Simpson JL, et ...

  18. Prenatal care in your third trimester

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000558.htm Prenatal care in your third trimester To use the sharing ... Gregory KD, Ramos DE, Jauniaux ERM. Preconception and prenatal care. In: Gabbe SG, Niebyl JR, Simpson JL, et ...

  19. Prenatal care in your first trimester

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000544.htm Prenatal care in your first trimester To use the sharing ... Gregory KD, Ramos DE, Jauniaux ERM. Preconception and prenatal care. In: Gabbe SG, Niebyl JR, Simpson JL, et ...

  20. Applications of Doppler in the first trimester

    International Nuclear Information System (INIS)

    Taylor, K.J.W.; Ramirez, B.; Grannum, P.

    1986-01-01

    Fifty patients have been studied by duplex Doppler US imaging in the first trimester. In normal gestations, luteal flow, characterized by a low pulsatility index (PI), can be seen in at least one ovary. Failure to detect luteal flow indicates a nonviable pregnancy. Six ectopic pregnancies demonstrated luteal flow and extrauterine heartbeat, detected by Doppler US. High PI values in the uterine artery are seen in the first trimester. Low PI values in the uterine arteries were found in patients with trophoblastic disease

  1. Comparative study of age estimation using dentinal translucency by digital and conventional methods.

    Science.gov (United States)

    Bommannavar, Sushma; Kulkarni, Meena

    2015-01-01

    Estimating age using the dentition plays a significant role in identification of the individual in forensic cases. Teeth are one of the most durable and strongest structures in the human body. The morphology and arrangement of teeth vary from person-to-person and is unique to an individual as are the fingerprints. Therefore, the use of dentition is the method of choice in the identification of the unknown. Root dentin translucency is considered to be one of the best parameters for dental age estimation. Traditionally, root dentin translucency was measured using calipers. Recently, the use of custom built software programs have been proposed for the same. The present study describes a method to measure root dentin translucency on sectioned teeth using a custom built software program Adobe Photoshop 7.0 version (Adobe system Inc, Mountain View California). A total of 50 single rooted teeth were sectioned longitudinally to derive a 0.25 mm uniform thickness and the root dentin translucency was measured using digital and caliper methods and compared. The Gustafson's morphohistologic approach is used in this study. Correlation coefficients of translucency measurements to age were statistically significant for both the methods (P image editing software. Furthermore, this method is easy to use and less time consuming. The measurements obtained using this method are more precise and thus help in more accurate age estimation. Considering these benefits, the present study recommends the use of digital method to assess translucency for age estimation.

  2. Realities in Science Data and Information - Let's go for translucency

    Science.gov (United States)

    Fox, P. A.

    2010-12-01

    The availability of rich and diverse science data and information sources is increasing at an staggering rate. In addition, many forms of those products are becoming valued and used by completely new consumers. These products range from just the "raw" data (examples such as the U.S. data.gov and climate system models) to highly quality controlled and integrated. With this mix of products, and diversity of uses, what is now becoming obvious is that issues such as fitness-for-purpose, quality and the need to establish some form of trust have not had sufficient attention paid to them by those providing and disseminating the data and information. The current demand is for transparency in data and information systems as well as at sources. Often this demand cannot be met, at all, or without significant resource allocations. This presentation will present the idea that transparency is not a realistic goal to address the questions that are being asked. Instead, filtered views into data and information systems, i.e. translucency is both more realistic and desirable. The issues surrounding the entire ecosystem of factors (e.g. explanation, verification, etc.) will be presented and discussed as well as how modern informatics developments are addressing many of the required components.

  3. View-through characterization of translucent fabrics based on opto-digital image analysis

    Science.gov (United States)

    Escofet, Jaume; Mitjà, Carles; Ralló, Miquel; Millán, Maria S.

    2012-06-01

    Translucent fabrics transmit light but provide sufficient diffusion to eliminate perception of distinct images. Traditional translucent woven fabrics include organdie, silk chiffon and muslin cotton, among many others. When such materials are used in curtains they provide even light transmission, solar protection and natural lighting, with a wide range of degrees of view-through. Since all these properties can be referred to the concepts of privacy, space and boundary, they are highly appreciated in interior design and architecture. The conventional metrics used to characterize a translucent fabric are the UV or Visible light transmission, the cover factor and the shading coefficient. In this work we propose to use other metrics commonly utilized to characterize imaging systems such as the Modulation Transfer Function (MTF). When looking through a curtain, the translucent fabric can be modeled as a low-pass filter that is combined with human eye imaging system. We replace our visual system by a high-quality still photographic camera. The MTF curve allows one to characterize the view-through performance of the translucent fabric in a more realistic way than the simple light transmittance, cover factor or shading coefficient. Two object tests, placed at a distance from the fabric, have been used to experimentally derive the MTF of the whole imaging system (translucent fabric and camera): a USAF test and a Slanted Edge (ES) test. In the latter case the Line Spread Function (LSF) is firstly obtained and the MTF estimated. The method has been applied to a set of translucent fabrics with different thread diameters and densities. From the MTF curves obtained using both tests, the transparency of the fabrics is objectively and quantitatively characterized in terms of view-through. The results are presented and discussed.

  4. Limitations of Aneuploidy and Anomaly Detection in the Obese Patient

    OpenAIRE

    Zozzaro-Smith, Paula; Gray, Lisa M.; Bacak, Stephen J.; Thornburg, Loralei L.

    2014-01-01

    Obesity is a worldwide epidemic and can have a profound effect on pregnancy risks. Obese patients tend to be older and are at increased risk for structural fetal anomalies and aneuploidy, making screening options critically important for these women. Failure rates for first-trimester nuchal translucency (NT) screening increase with obesity, while the ability to detect soft-markers declines, limiting ultrasound-based screening options. Obesity also decreases the chances of completing the anato...

  5. Microhardness assessment of different commercial brands of resin composites with different degrees of translucence

    Directory of Open Access Journals (Sweden)

    Taciana Emília de Almeida Anfe

    2008-12-01

    Full Text Available Owing to improvements in its mechanical properties and to the availability of shade and translucence resources, resin composite has become one of the most widely used restorative materials in present day Dentistry. The aim of this study was to assess the relation between the surface hardness of seven different commercial brands of resin composites (Charisma, Fill Magic, Master Fill, Natural Look, Opallis, Tetric Ceram, and Z250 and the different degrees of translucence (translucid, enamel and dentin. Vickers microhardness testing revealed significant differences among the groups. Z250 was the commercial brand that showed the best performance in the hardness test. When comparing the three groups assessed within the same brand, only Master Fill and Fill Magic presented statistically significant differences among all of the different translucencies. Natural Look was the only one that showed no significant difference among any of the three groups. Charisma, Opallis, Tetric Ceram and Z250 showed significant differences among some of the tested groups. Based on the results found in this study, it was not possible to establish a relation between translucence and the microhardness of the resin composites assessed. Depending on the material assessed, however, translucence variation did affect the microhardness values of the resin composites.

  6. Correlation between the ossification of nuchal ligament and clinical cervical disorders

    Directory of Open Access Journals (Sweden)

    Yu-Lin Tsai

    2012-10-01

    Full Text Available This is a correlation analysis between severity of the ossification of the nuchal ligament (ONL and clinical cervical disorders including neck dysfunction, cervical malalignment, and morphologic changes of the cervical neural foramen (CNF. The clinical effects of ONL on active range of motion (AROM of neck, cervical radiculopathy, abnormal cervical curvature, and the degree of CNF stenosis in patients with painful neck stiffness are investigated. Studies have investigated the predisposing factors to cervical dysfunction and degenerative disorders; however, few studies have examined the influence of the ONL on neck function and cervical spine. A total of 31 participants with painful neck stiffness were recruited. They accepted measurement of cervical AROM and serial cervical radiographs at anterior–posterior view, lateral view, and bilateral oblique views. Parameters of radiographs measurement included cervical lordotic curve, and cross-sectional areas (CSA of the ONL and CNF (C2–C3, C4–C5, C5–C6, and C6–C7 levels. The ratio of CSA of the lower CNF (C4–C5, C5–C6, C6–C7 to CSA of the upper CNF (C2–C3 was used as a CNF stenosis ratio. The correlations of ONL size, neck symptoms, cervical AROM, lordotic curve, and CNF stenosis ratio were analyzed. More than half of all patients were positive in cervical root signs and prone to have larger ONL. Neck AROM of all participants was significantly below normal average in all directions, and a moderate negative association was found between the ONL CSA and AROM in flexion–extension. Most patients had moderate loss of cervical lordotic curve despite there being no significant correlation between ONL CSA and cervical curvature. Moreover, CNF stenosis ratio significantly negatively correlated with ONL CSA. Patients with larger ONL had more severe cervical radiculopathy, more stiffness in flexion–extension direction, more complex degenerative change of spine, and worse CNF stenosis.

  7. Prenatal diagnosis of OEIS (omphalocele, bladder exstrophy, imperforate anus, clubfeet) variant associated with increased nuchal translucency and OEIS complex with ambiguous genitalia associated with corrected transposition of the great arteries: case series and review of the literature.

    Science.gov (United States)

    Tonni, G; Grisolia, G; Bonasoni, M; Panteghini, M; Vito, I; De Felice, C

    2011-08-01

    The OEIS complex refers to a combination of defects consisting in omphalocele, bladder exstrophy, imperforate anus and spinal defects and represents a rare nosologic entity (from 1:200,000 to 1:400,000 pregnancies). The defect probably occurs in early blastogenesis or in mesodermal migration during the primitive streak period. Two cases of OEIS complex diagnosed prenatally by ultrasound are reported. The medical record regarding differential diagnosis, associated anomalies, treatment and prognosis has also been sought and reported. Differential diagnosis with exstrophy-epispadias complex and/or cloacalexstrophy complex may be difficult antenatally by means of ultrasound. However, color Doppler has been proved to aid the diagnosis of bladder exstrophy by depicting the urine flow in direct communication with the abdominal cavity and has been useful in showing the course of the perivesical umbilical arteries. Prenatal 3D ultrasound with tomographic ultrasound imaging (TUI) and antenatal MR imaging might be useful adjuncts to conventional 2D scan in aiding the prenatal diagnosis of such malformation.

  8. Diagnosis and prediction of parental origin of triploidies by fetal nuchal translucency and maternal serum free beta-hCG and PAPP-A at 11-14 weeks of gestation

    DEFF Research Database (Denmark)

    Barken, Sidsel Svennekjær; Skibsted, L.; Jensen, Lars Nimb

    2008-01-01

    The study objective was to determine the parental origin of triploidy in relation to findings from early risk assessment in a combined screening program between 2004 and the end of 2006. Triploidy was diagnosed in six chorion villus samples and two samples from missed abortions. After informed...

  9. Fracture Resistance of Monolithic High Translucency Zirconia Implant-Supported Crowns.

    Science.gov (United States)

    Brizuela-Velasco, Aritza; Diéguez-Pereira, Markel; Álvarez-Arenal, Ángel; Chávarri-Prado, David; Solaberrieta, Eneko; Fernández-González, Felipe J; Chento-Valiente, Yelko; Santamaría-Arrieta, Gorka

    2016-10-01

    To evaluate the resistance to axial forces of screw-retained monolithic high translucency zirconia (mHTZr) crowns compared with high translucency zirconia + feldspathic ceramic (HTZrC) crowns, low translucency zirconia + feldspathic ceramic (LTZrC) crowns, and metal-ceramic (MC) crowns, and also to observe the different fracture patterns between all groups. Twenty-four crowns were fabricated (6 of each group) and loaded until failure, using a testing machine with a 5.0-kN load cell. Mean fracture results varied between 1092.7 N (LTZrC group) and 3439.7 N (mHTZr group). No statistically significant differences were found between the HTZrC, LTZrC, and MC groups. However, statistically significant differences (P zirconia implant-supported crowns proved to be the toughest group studied when an axial force was applied. Fracture patterns varied between different materials, chipping being the most common occurrence.

  10. Validity Comparison of Three Dental Methods for Age Estimation Based on Tooth Root Translucency.

    Science.gov (United States)

    Santoro, Valeria; Fiandaca, Chiara; Roca, Roberta; Marini, Chiara; De Donno, Antonio; Introna, Francesco

    2015-09-01

    Age estimation of nonliving subjects plays a very important role in identifying human remains. When adult remains are in question, this process becomes even more complex. Among the numerous dental methods that exist for adults aging, the evaluation of root translucency is one of the most useful. This study studies the correlation between age and root translucency by investigating monoradicular teeth affected by pathological processes using the equations proposed by Lamendin, Prince & Ubelaker and from Singhal et al. The average age values calculated according to the three methods were compared with the values of known age. Age estimation using the Student's t-test resulted as more accurate in the methods by Singhal et al. and by Prince & Ubelaker, with respect to that of Lamendin. Age estimation based solely on the percentage of radicular dentinal translucency has been found to be more accurate when diseased teeth are involved. © 2015 American Academy of Forensic Sciences.

  11. Translucency of IPS e.max and cubic zirconia monolithic crowns.

    Science.gov (United States)

    Baldissara, Paolo; Wandscher, Vinícius Felipe; Marchionatti, Ana Maria Estivalete; Parisi, Candida; Monaco, Carlo; Ciocca, Leonardo

    2018-02-21

    Although several monolithic zirconia ceramics have recently been introduced, the need for improved optical properties remains. The newest cubic-zirconia has been claimed to have optimal translucency characteristics for esthetic restorations. This in vitro study evaluated the optical properties of novel cubic ultratranslucent (UT) and supertranslucent (ST) zirconia by comparing them with lithium disilicate (L-DIS) glass-ceramic for the manufacture of monolithic computer-aided design and computer-aided manufacturing (CAD-CAM) molar crowns. The UT and ST multilayered zirconia and the low-translucency grade L-DIS were milled. Eighty monolithic crowns were made from 2 CAD files, corresponding to thicknesses of 1.0 and 1.5 mm, and subdivided (n=20) into 4 groups: UT1.0, UT1.5, ST1.0, and L-DIS1.5. All groups were shaded using A2 color standard. Translucency of the crowns was measured by total transmission, using a photoradiometer in a dark chamber; furthermore, the contrast ratio was analyzed using a dental spectrophotometer applied to the buccal surface of the crowns. Data were analyzed using the Kruskal-Wallis and post hoc multiple Mann-Whitney U tests with Bonferroni correction (α=.05 divided by the number of tests performed in each set). When the ceramic types were analyzed, using total transmission and contrast methods, they showed significantly different translucency levels: UT1.0>ST1.0>UT1.5>L-DIS1.5 (total transmission Pcrowns, even at the maximum thickness tested (UT1.5), showed significantly higher translucency than L-DIS. Zirconia translucency was improved by eliminating the tetragonal phase, which is responsible for the toughening effect; thus, further studies are advocated to investigate the mechanical resistance of cubic zirconia. Copyright © 2017 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  12. Comparative study of age estimation using dentinal translucency by digital and conventional methods

    Science.gov (United States)

    Bommannavar, Sushma; Kulkarni, Meena

    2015-01-01

    Introduction: Estimating age using the dentition plays a significant role in identification of the individual in forensic cases. Teeth are one of the most durable and strongest structures in the human body. The morphology and arrangement of teeth vary from person-to-person and is unique to an individual as are the fingerprints. Therefore, the use of dentition is the method of choice in the identification of the unknown. Root dentin translucency is considered to be one of the best parameters for dental age estimation. Traditionally, root dentin translucency was measured using calipers. Recently, the use of custom built software programs have been proposed for the same. Objectives: The present study describes a method to measure root dentin translucency on sectioned teeth using a custom built software program Adobe Photoshop 7.0 version (Adobe system Inc, Mountain View California). Materials and Methods: A total of 50 single rooted teeth were sectioned longitudinally to derive a 0.25 mm uniform thickness and the root dentin translucency was measured using digital and caliper methods and compared. The Gustafson's morphohistologic approach is used in this study. Results: Correlation coefficients of translucency measurements to age were statistically significant for both the methods (P < 0.125) and linear regression equations derived from both methods revealed better ability of the digital method to assess age. Conclusion: The custom built software program used in the present study is commercially available and widely used image editing software. Furthermore, this method is easy to use and less time consuming. The measurements obtained using this method are more precise and thus help in more accurate age estimation. Considering these benefits, the present study recommends the use of digital method to assess translucency for age estimation. PMID:25709325

  13. Estrogen Levels in the three Trimesters

    African Journals Online (AJOL)

    estrogen levels in first, second and third trimesters of pregnant albino rats. MATERIALS AND METHODS. TEST SUBJECTS. 20 female albino rats and 6 male albino rats, with initial weight of 165-180g were purchase from the animal house of Department of Animal and. Environmental Biology , University of Benin,. Benin city ...

  14. First trimester growth restriction and uterine artery blood flow in the second trimester as predictors of adverse pregnancy outcome

    DEFF Research Database (Denmark)

    Pedersen, N G; Sperling, L; Wøjdemann, K R

    2013-01-01

    To investigate if fetuses with first trimester growth restriction have poorer perfusion of the placenta compared to a control group, and to investigate whether first trimester growth restriction in combination with poor flow in the uterine arteries in the second trimester can be used to predict...

  15. Effect of Translucency on Transparency and Symbol Learning for Children with and without Cerebral Palsy

    Science.gov (United States)

    Huang, Chih-Hsiung; Chen, Ming-Chung

    2011-01-01

    Based on the concept of iconicity, the iconicity hypothesis was emphasized for decades. The aims of this study were to explore the effect of translucency on transparency and symbol learning for children with and without cerebral palsy. Twenty children with cerebral palsy and forty typical peers participated in the study. Ten symbols with high…

  16. Analysis of radiography findings of ossification of nuchal ligament of cervical spine in patients with cervical spondylosis.

    Science.gov (United States)

    Wang, Hongli; Zou, Fei; Jiang, Jianyuan; Lu, Feizhou; Chen, Wenjun; Ma, Xiaosheng; Xia, Xinlei; Wang, Lixun

    2014-01-01

    Retrospective clinical data analysis. This study was conducted to investigate the incidence, related factors, and radiography findings of ossification of the nuchal ligament (ONL) in patient with cervical spondylosis, which could serve as a basis for further studies of the relationships between ONL and cervical spondylosis. Injury to nuchal ligament, which might cause ONL, may aggravate cervical spine instability, leading to cervical spondylosis. Thus, it is important to understand the characteristics of ONL in patients who are diagnosed with cervical spondylosis. Medical records of 372 patients with cervical spondylosis were reviewed. Data analysis included patients' sex, age, location and classification of ONL, and ossification of the posterior longitudinal ligament (OPLL). Radiological features were evaluated by lateral plain radiography and computed tomography for 2-dimensional sagittal plane reconstruction. Of the 372 patients with cervical spondylosis, 49.7% had a diagnosis of ONL; the incidence of ONL was higher in males than in females (P = 0.001) and in elderly patients than in young patients (P = 0.005). The varying pictures of ONL on the plain radiography were classified into 5 types: local, continuous, segmental, mixed, and unclassified, and the distribution was 49.7%, 33.0%, 3.2%, 8.6%, and 5.4%, respectively. ONL occurred mostly at the level of C4,5 (75.7%) and C5,6 (81.1%). The incidence of ONL was higher in patients with OPLL than others (P spondylosis. Sex, age, and OPLL are related factors of ONL. ONL can be classified into different types through morphology. Local type is the most common type of ONL, and multilevel ONL occurs mostly in patients with OPLL. C4,5 and C5,6 are the levels where ONL occurs mostly. 4.

  17. The effect of home-bleaching application on the color and translucency of five resin composites.

    Science.gov (United States)

    Kurtulmus-Yilmaz, Sevcan; Cengiz, Esra; Ulusoy, Nuran; Ozak, Sule Tugba; Yuksel, Ece

    2013-11-01

    The aim of this study was to investigate the effect of home bleaching agents on the color and translucency of resin composites. Thirty disc shaped specimens (1mm thick) were fabricated from each resin composite (Reflexions, Grandio, Gradia Direct, Clearfil Majesty Esthetic, Ceram-X Mono) and divided into 3 subgroups as carbamide peroxide (CP, Opalescence 10% PF), hydrogen peroxide (HP, 10% Opalescence Treswhite Supreme) and control group (n=10). Baseline CIE L*a*b* color coordinates were measured with spectrophotometer and translucency parameters (TP) were calculated. CP and HP groups were treated with bleaching agents according to manufacturers' instructions and control group was stored in distilled water (DW) for 14 days. Color and translucency measurements were repeated and color differences were calculated, ΔE values>3.3 were considered as clinically unacceptable. Clinically unacceptable color change was detected for all resin composites exposed to bleaching agents and there was significant color difference between the control group and bleached specimens (P<0.05). However no significant color difference was found between CP and HP groups. Intragroup comparison revealed that Ceram-X Mono showed the highest color change but there was no significant difference among the other tested materials for both CP and HP groups. Intergroup comparison of TP values of CP, HP and control groups at the end of 14th day revealed that there was no statistical significant translucency difference among the groups. Application of CP and HP resulted in clinically unacceptable color change for all resin composites. Translucencies of the resin composites were not affected by bleaching procedure. The results of this in vitro study suggest that patients should be informed regarding a potential color change of existing resin composite restorations with the use of home bleaching agents. Copyright © 2013 Elsevier Ltd. All rights reserved.

  18. Influence of type of cement on the color and translucency of monolithic zirconia.

    Science.gov (United States)

    Malkondu, Ozlem; Tinastepe, Neslihan; Kazazoglu, Ender

    2016-12-01

    With the development of translucent zirconia, questions regarding the influence of cements on the final color of monolithic zirconia restorations have arisen. The purpose of this in vitro study was to evaluate color changes in terms of the perceptibility and acceptability of monolithic zirconia-and-cement combinations with 2 monolithic zirconia thicknesses and 3 types of cement. The translucency parameters of these combinations were also compared. Sixty monolithic zirconia ceramic disks were milled with 2 different thicknesses (0.6 mm and 1 mm). A conventional glass ionomer cement, a resin-modified glass ionomer cement, and a resin cement from the same manufacturer were applied to the ceramic surfaces of both thickness disks (n=10). Translucencies and color changes of the monolithic zirconia specimens after cement application were examined by using a spectrophotometer, and translucency parameters (TPs) and color changes (ΔEs) were calculated and statistically analyzed. Colors and TPs of the zirconia disks changed significantly after being cemented to 0.6- and 1-mm-thick disks (Pzirconia-resin modified glass ionomer combination, whereas the highest ΔE values (5.64 for the 0.6-mm and 5.06 for the 1-mm thick disks) were observed for the zirconia-resin cement combination. The glass ionomer cement most strongly affected the TP values of both of the thicknesses. Cement types and zirconia thickness affected the colors and translucencies of the monolithic zirconia specimens. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  19. Influence of resin cement shade on the color and translucency of ceramic veneers

    Directory of Open Access Journals (Sweden)

    Daiana Kelly Lopes HERNANDES

    Full Text Available ABSTRACT Objective This in vitro study evaluated the effect of two different shades of resin cement (RC- A1 and A3 layer on color change, translucency parameter (TP, and chroma of low (LT and high (HT translucent reinforced lithium disilicate ceramic laminates. Material and Methods One dual-cured RC (Variolink II, A1- and A3-shade, Ivoclar Vivadent was applied to 1-mm thick ceramic discs to create thin RC films (100 µm thick under the ceramics. The RC was exposed to light from a LED curing unit. Color change (ΔE of ceramic discs was measured according to CIEL*a*b* system with a standard illuminant D65 in reflectance mode in a spectrophotometer, operating in the light range of 360-740 nm, equipped with an integrating sphere. The color difference between black (B and white (W background readings was used for TP analysis, while chroma was calculated by the formula C*ab=(a*2+b*2½. ΔE of 3.3 was set as the threshold of clinically unacceptable. The results were evaluated by two-way ANOVA followed by Tukey's post hoc test. Results HT ceramics showed higher ΔE and higher TP than LT ceramics. A3-shade RC promoted higher ΔE than A1-shade cement, regardless of the ceramic translucency. No significant difference in TP was noted between ceramic discs with A1- and those with A3-shade cement. Ceramic with underlying RC showed lower TP than discs without RC. HT ceramics showed lower chroma than LT ceramics, regardless of the resin cement shade. The presence of A3-shade RC resulted in higher chroma than the presence of A1-shade RC. Conclusions Darker underlying RC layer promoted more pronounced changes in ceramic translucency, chroma, and shade of high translucent ceramic veneers. These differences may not be clinically differentiable.

  20. Translucency and masking properties of two ceramic materials for heat-press technology.

    Science.gov (United States)

    Șoim, Alexandra; Strîmbu, Maria; Burde, Alexandru V; Culic, Bogdan; Dudea, Diana; Gasparik, Cristina

    2018-03-01

    To assess the translucency of two pressable ceramics and to analyze their masking property when placed on different tooth-shaded backgrounds. Thirty discs (1-mm thickness) were fabricated using two pressable ceramics (shade/translucency): 1M1T/HT, 1M2T/HT, 2M2T (VITA PM9), and A1LT/HT, B1LT/HT, A2LT (e.max Press). Color measurements of discs were performed with a dental spectrophotometer on tooth-colored backgrounds (A1/A2/A3/A3.5/A4), and black and white backings. The masking property was calculated as the color difference (CIEDE2000) between parameters of discs on control (A1, A2) and test backgrounds (A3, A3.5, A4). One-way ANOVA was used for assessing differences in translucency parameter (TP) between ceramics. Two-way ANOVA was used for detecting differences among groups when measured over tooth-shaded backgrounds (α = 0.05, Bonferroni correction). TP ranged between 14.96 (B1LT) and 25.18 (1M1HT). A significant difference in TP was found between tested ceramics (F = 949.949, P  .05), 1M1T, A1HT and B1HT (P > .05), 1M2T, 2M2T, and A2HT (P > .05). A significant interaction effect of underlying background on color of ceramic discs was found (F = 107.994, P ceramics. Except A1LT, all ceramic materials evaluated showed poor masking properties on A4 background. Highly translucent ceramics should be wisely used for restoring the appearance of dental structures since background color has a large effect upon these materials. The more recently introduced pressable ceramics showed high levels of translucency. © 2018 Wiley Periodicals, Inc.

  1. Influence of resin cement shade on the color and translucency of ceramic veneers.

    Science.gov (United States)

    Hernandes, Daiana Kelly Lopes; Arrais, Cesar Augusto Galvão; Lima, Erick de; Cesar, Paulo Francisco; Rodrigues, José Augusto

    2016-01-01

    This in vitro study evaluated the effect of two different shades of resin cement (RC- A1 and A3) layer on color change, translucency parameter (TP), and chroma of low (LT) and high (HT) translucent reinforced lithium disilicate ceramic laminates. One dual-cured RC (Variolink II, A1- and A3-shade, Ivoclar Vivadent) was applied to 1-mm thick ceramic discs to create thin RC films (100 µm thick) under the ceramics. The RC was exposed to light from a LED curing unit. Color change (ΔE) of ceramic discs was measured according to CIEL*a*b* system with a standard illuminant D65 in reflectance mode in a spectrophotometer, operating in the light range of 360-740 nm, equipped with an integrating sphere. The color difference between black (B) and white (W) background readings was used for TP analysis, while chroma was calculated by the formula C*ab=(a*2+b*2)½. ΔE of 3.3 was set as the threshold of clinically unacceptable. The results were evaluated by two-way ANOVA followed by Tukey's post hoc test. HT ceramics showed higher ΔE and higher TP than LT ceramics. A3-shade RC promoted higher ΔE than A1-shade cement, regardless of the ceramic translucency. No significant difference in TP was noted between ceramic discs with A1- and those with A3-shade cement. Ceramic with underlying RC showed lower TP than discs without RC. HT ceramics showed lower chroma than LT ceramics, regardless of the resin cement shade. The presence of A3-shade RC resulted in higher chroma than the presence of A1-shade RC. Darker underlying RC layer promoted more pronounced changes in ceramic translucency, chroma, and shade of high translucent ceramic veneers. These differences may not be clinically differentiable.

  2. First trimester diagnosis and screening for fetal aneuploidy

    OpenAIRE

    Driscoll, Deborah A.; Gross, Susan J.

    2008-01-01

    Maternal serum screening for neural tube defects and fetal aneuploidy in the second trimester has been incorporated into obstetrical practice over the past two decades. Now, as a result of several multicenter trials, first trimester screening between 11 and 14 weeks has been shown to be an effective and reliable screening test for Down syndrome and trisomy 18. Benefits of first trimester screening include earlier identification of the pregnancy at risk for fetal aneuploidy and anatomic defect...

  3. Bionics in textiles: flexible and translucent thermal insulations for solar thermal applications.

    Science.gov (United States)

    Stegmaier, Thomas; Linke, Michael; Planck, Heinrich

    2009-05-13

    Solar thermal collectors used at present consist of rigid and heavy materials, which are the reasons for their immobility. Based on the solar function of polar bear fur and skin, new collector systems are in development, which are flexible and mobile. The developed transparent heat insulation material consists of a spacer textile based on translucent polymer fibres coated with transparent silicone rubber. For incident light of the visible spectrum the system is translucent, but impermeable for ultraviolet radiation. Owing to its structure it shows a reduced heat loss by convection. Heat loss by the emission of long-wave radiation can be prevented by a suitable low-emission coating. Suitable treatment of the silicone surface protects it against soiling. In combination with further insulation materials and flow systems, complete flexible solar collector systems are in development.

  4. [Functional study in early strabismus: translucent screens and electro-nystagmography].

    Science.gov (United States)

    Spielmann, A

    1990-01-01

    The symptoms of infantile strabismus are triggered by fixation, chiefly monocular fixation. On the excluded eye, "occlusion deviations" (elevation, esodeviation, extorsion) are well observed through a "translucent" unilateral cover. These deviations are super-imposed upon a position of rest without fixation which may be an orthoposition, well observed through bilateral translucent occluders. They are caused by a rupture of binocular retinal stimuli which does not mean rupture of fusion (ex: the darkening Bielschowsky test). Electro-oculographic studies confirm the prevalence of adduction during fixation (nystagmus, pursuit, optokinetic nystagmus). This directional asymmetry is typical of the infant's immature system of fixation. In infantile strabismus, it persists because of missing binocular links (corpus callosum--cortex----midbrain) as shown by the study of the so-called congenital monophthalm syndrome (unilateral congenital blindness).

  5. Nanocellulose-based Translucent Diffuser for Optoelectronic Device Applications with Dramatic Improvement of Light Coupling.

    Science.gov (United States)

    Wu, Wei; Tassi, Nancy G; Zhu, Hongli; Fang, Zhiqiang; Hu, Liangbing

    2015-12-09

    Nanocellulose is a biogenerated and biorenewable organic material. Using a process based on 2,2,6,6-tetramethylpiperidine-1-oxyl (TEMPO)/NaClO/NaBr system, a highly translucent and light-diffusive film consisting of many layers of nanocellulose fibers and wood pulp microfibers was made. The film demonstrates a combination of large optical transmittance of ∼90% and tunable diffuse transmission of up to ∼78% across the visible and near-infrared spectra. The detailed characterizations of the film indicate the combination of high optical transmittance and haze is due to the film's large packing density and microstructured surface. The superior optical properties make the film a translucent light diffuser and applicable for improving the efficiencies of optoelectronic devices such as thin-film silicon solar cells and organic light-emitting devices.

  6. Differences in color, translucency and fluorescence between flowable and universal resin composites.

    Science.gov (United States)

    Yu, Bin; Lee, Yong-Keun

    2008-10-01

    To evaluate the optical properties such as color, translucency and fluorescence of flowable resin composites, and compare them with the corresponding shade universal resin composites of the same brand. Four brands of flowable and universal resin composites of the same shade designation (A2) were investigated. Color of specimens (2mm in thickness) was measured after polymerization on a reflection spectrophotometer over background of white, black and each corresponding composite material itself. Color differences (DeltaE(ab)(*)) between each combination of resin composites were determined. Translucency parameter (TP) and color difference by the fluorescent emission (DeltaE(ab)(*)-FL) of materials were also calculated. Differences in the optical properties of flowable and universal resin composites were analyzed with one-way ANOVA. DeltaE(ab)(*) between the flowable and the corresponding universal resin composites was in the range of 1.0-6.0 DeltaE(ab)(*) units, which was perceptible (DeltaE(ab)(*)>2.6) in three brands. Flowable resin composites revealed lower TP values in two of the four brands. DeltaE(ab)(*) between flowable and the corresponding universal resin composites was influenced by their difference in translucency. All the four universal resin composites and two flowable resin composites showed fluorescent peak, and the range of DeltaE(ab)(*)-FL was 0.3-2.3 DeltaE(ab)(*) units. Optical properties of flowable and universal resin composites was significantly different (presin composites should be considered for clinically acceptable color matching.

  7. Effect of Home Bleaching on the Translucency of CAD/CAM Systems.

    Science.gov (United States)

    Karci, Muhammet; Demir, Necla

    2017-11-10

    To evaluate the effect of a home bleaching agent (Opalescence PF) on the translucency of CAD/CAM ceramic systems. The 28 sintered ceramic specimens (IPS Empress CAD and IPS e.max CAD; 15 mm long, 10 mm wide, 1 mm thick) were divided into two subgroups as control and bleaching groups (n = 7). Carbamide peroxide (CP), 16%, home bleaching agent was applied onto the surface of each specimen for 6 hours per day for 7 days. A spectrophotometer (VITA Easyshade Advance) was used to measure the CIE L * a * b * coordinates and the reflectance value (Y) of the specimens on white and black backgrounds. The translucency parameter (TP), contrast ratio (CR), and opalescence parameter (OP) of the specimens were calculated. The data were statistically analyzed using Kolmogorov-Smirnov, one-way ANOVA, Tukey's test, and Pearson's correlation. Statistically significant differences in the TP values after 16% CP bleaching treatment were observed (p ˂ 0.05); however, no significant differences were found in the OP and CR values after the surface treatment (p ˃ 0.05). According to our study, patients who have all-ceramic restorations in their mouths should be careful when using home bleaching agents, because whitening agents can affect the translucency of all-ceramic restorations such as e.max CAD and Empress CAD. © 2017 by the American College of Prosthodontists.

  8. Comparison of stabilities in translucency, fluorescence and opalescence of direct and indirect composite resins.

    Science.gov (United States)

    Yu, Bin; Lee, Young-Keun

    2013-01-01

    To evaluate translucency, fluorescence and opalescence stabilities of direct and indirect composite resins after aging. One direct (16 shades) and two indirect composite resins (16 and 26 shades) were investigated. Resins were filled in a mold (1 mm thick) and light cured; post-curings were performed for indirect resins. Color was measured before and after 5,000 cycles of thermocycling on a reflection spectrophotometer in reflectance and transmittance modes to calculate parameters for translucency (TP), fluorescence (FL) and opalescence (OP). Differences in the changes of TP, FL and OP after aging by the type of resin were determined by t test, and those were also determined by one-way ANOVA with the factor of the brand or the shade group (P resins; and were -2.0 to 1.8, -0.9 to 0.4 and -2.9 to 3.7, respectively, for indirect resins. Changes in TP were not significantly different by the type of resin, but those in FL and OP were different (P = 0.05). Changes in optical parameters were influenced by the brand or the shade group of the resins (P resins varied depending on type, brand or shade group. Aging significantly affected fluorescence and opalescence, but not translucency, of indirect resins compared to those of direct resins.

  9. Systematic approach to preparing ceramic-glass composites with high translucency for dental restorations.

    Science.gov (United States)

    Yoshimura, Humberto N; Chimanski, Afonso; Cesar, Paulo F

    2015-10-01

    Ceramic composites are promising materials for dental restorations. However, it is difficult to prepare highly translucent composites due to the light scattering that occurs in multiphase ceramics. The objective of this work was to verify the effectiveness of a systematic approach in designing specific glass compositions with target properties in order to prepare glass infiltrated ceramic composites with high translucency. First it was necessary to calculate from literature data the viscosity of glass at the infiltration temperature using the SciGlass software. Then, a glass composition was designed for targeted viscosity and refractive index. The glass of the system SiO2-B2O3-Al2O3-La2O3-TiO2 prepared by melting the oxide raw materials was spontaneously infiltrated into porous alumina preforms at 1200°C. The optical properties were evaluated using a refractometer and a spectrophotometer. The absorption and scattering coefficients were calculated using the Kubelka-Munk model. The light transmittance of prepared composite was significantly higher than a commercial ceramic-glass composite, due to the matching of glass and preform refractive indexes which decreased the scattering, and also to the decrease in absorption coefficient. The proposed systematic approach was efficient for development of glass infiltrated ceramic composites with high translucency, which benefits include the better aesthetic performance of the final prosthesis. Copyright © 2015 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

  10. Gene expression in first trimester preeclampsia placenta.

    Science.gov (United States)

    Founds, Sandra A; Terhorst, Lauren A; Conrad, Kirk P; Hogge, W Allen; Jeyabalan, Arun; Conley, Yvette P

    2011-04-01

    The goal of this study was to further validate eight candidate genes identified in a microarray analysis of first trimester placentas in preeclampsia. Surplus chorionic villus sampling (CVS) specimens of 4 women subsequently diagnosed with preeclampsia (PE) and 8 control women (C) without preeclampsia analyzed previously by microarray and 24 independent additional control samples (AS) were submitted for confirmatory studies by quantitative real-time polymerase chain reaction (qRT-PCR). Downregulation was significant in FSTL3 in PE as compared to C and AS (p = .04). PAEP was downregulated, but the difference was only significant between C and AS (p = .002) rather than between PE and either of the control groups. Expression levels for CFH, EPAS1, IGFBP1, MMP12, and SEMA3C were not statistically different among groups, but trends were consistent with microarray results; there was no anti-correlation. S100A8 was not measurable in all samples, probably because different probes and primers were needed. This study corroborates reduced FSTL3 expression in the first trimester of preeclampsia. Nonsignificant trends in the other genes may require follow-up in studies powered for medium or medium/large effect sizes. qRT-PCR verification of the prior microarray of CVS may support the placental origins of preeclampsia hypothesis. Replication is needed for the candidate genes as potential biomarkers of susceptibility, early detection, and/or individualized care of maternal-infant preeclampsia.

  11. Waterproof and translucent wings at the same time: problems and solutions in butterflies

    Science.gov (United States)

    Perez Goodwyn, Pablo; Maezono, Yasunori; Hosoda, Naoe; Fujisaki, Kenji

    2009-07-01

    Although the colour of butterflies attracts the most attention, the waterproofing properties of their wings are also extremely interesting. Most butterfly wings are considered “super-hydrophobic” because the contact angle (CA) with a water drop exceeds 150°. Usually, butterfly wings are covered with strongly overlapping scales; however, in the case of transparent or translucent wings, scale cover is reduced; thus, the hydrophobicity could be affected. Here, we present a comparative analysis of wing hydrophobicity and its dependence on morphology for two species with translucent wings Parantica sita (Nymphalidae) and Parnassius glacialis (Papilionidae). These species have very different life histories: P. sita lives for up to 6 months as an adult and migrates over long distance, whereas P. glacialis lives for less than 1 month and does not migrate. We measured the water CA and analysed wing morphology with scanning electron microscopy and atomic force microscopy. P. sita has super-hydrophobic wing surfaces, with CA > 160°, whereas P. glacialis did not (CA = 100-135°). Specialised scales were found on the translucent portions of P. sita wings. These scales were ovoid and much thinner than common scales, erect at about 30°, and leaving up to 80% of the wing surface uncovered. The underlying bare wing surface had a remarkable pattern of ridges and knobs. P. glacialis also had over 80% of the wing surface uncovered, but the scales were either setae-like or spade-like. The bare surface of the wing had an irregular wavy smooth pattern. We suggest a mode of action that allows this super-hydrophobic effect with an incompletely covered wing surface. The scales bend, but do not collapse, under the pressure of a water droplet, and the elastic recovery of the structure at the borders of the droplet allows a high apparent CA. Thus, P. sita can be translucent without losing its waterproof properties. This characteristic is likely necessary for the long life and migration

  12. The correlation between ossification of the nuchal ligament and pathological changes of the cervical spine in patients with cervical spondylosis.

    Science.gov (United States)

    Wang, Hongli; Zou, Fei; Jiang, Jianyuan; Lu, Feizhou; Chen, Wenjun; Ma, Xiaosheng; Xia, Xinlei; Wang, Lixun

    2014-12-15

    A retrospective clinical data analysis. This study was conducted to investigate the correlation between ossification of the nuchal ligament (ONL) and pathological changes of the cervical spine in patients with cervical spondylosis. ONL can usually be found in cervical spondylosis. Thus, it is important to find the correlation between ONL and pathological changes of the cervical spine in patients with cervical spondylosis. The medical records of 100 patients with cervical spondylosis with the local type of ONL (ONL group) and 50 patients with cervical spondylosis only (control group) were reviewed. Data analysis included patients' sex, age, location of ONL, maximum cord compression level, osteophyte height ratio, and grade of cervical intervertebral disc degeneration. Radiological features were evaluated by lateral plain radiography and magnetic resonance imaging. In total, 69.0% of subjects in the ONL group had ONL located at the maximum cord compression level; there was no difference based on sex (P = 0.248). The value of the osteophyte height ratio was higher at the ONL level than at its superior and inferior adjacent segments (P spondylosis.

  13. Oxidative Stress during the Various Trimesters of Pregnancy in ...

    African Journals Online (AJOL)

    Oxidative stress during the various trimesters of pregnancy in humans was investigated. Venous blood was taken from 30 pregnant women, comprising 10 each at first, second and third trimesters. Additionally, blood was taken from 10 non-pregnant women, and was used as control. The plasma was quickly extracted and ...

  14. Urea and Creatinine Clearances in the Three Trimesters of Pregnancy

    African Journals Online (AJOL)

    Abstract. The aim of this study was to determine the creatinine and urea clearances, as indices of glomerular filtration rate (GFR) during the three trimesters of pregnancy. A total of 108 healthy subjects between the ages of 18 and 37years were divided into non-pregnant women (28+5years, n=30), 1st trimester of pregnancy ...

  15. First-trimester vaginal bleeding and complications later in pregnancy

    DEFF Research Database (Denmark)

    Lykke, Jacob Alexander; Dideriksen, Katrine Lehrmann; Lidegaard, Øjvind

    2010-01-01

    To evaluate the association of first-trimester bleeding without miscarriage and complications later in the first pregnancy as well as in the next pregnancy.......To evaluate the association of first-trimester bleeding without miscarriage and complications later in the first pregnancy as well as in the next pregnancy....

  16. Serum electrolyte values of cows during third trimester of pregnancy ...

    African Journals Online (AJOL)

    Some serum electrolyte values of 170 cows in eight settled cattle herds in Zaria, Northern Nigeria during the third trimester of pregnancy and first two weeks of lactation were determined. The cows were sampled once weekly during the third trimester of pregnancy and early lactation (first two weeks) periods for two ...

  17. The Application of First‑Trimester Volumetry in Predicting Pregnancy ...

    African Journals Online (AJOL)

    Relevant materials on first trimester volumetry were selected. Placenta volumes ... In obstetric sonography, standardization of the 3D volumetric methodology is needed to improve reproducibility of measurement. The accuracy of ... its applicability. Keywords: 3D ultrasound, first trimester, pregnancy complications, volumetry ...

  18. First trimester diagnosis and screening for fetal aneuploidy

    Science.gov (United States)

    Driscoll, Deborah A.; Gross, Susan J.

    2008-01-01

    Maternal serum screening for neural tube defects and fetal aneuploidy in the second trimester has been incorporated into obstetrical practice over the past two decades. Now, as a result of several multicenter trials, first trimester screening between 11 and 14 weeks has been shown to be an effective and reliable screening test for Down syndrome and trisomy 18. Benefits of first trimester screening include earlier identification of the pregnancy at risk for fetal aneuploidy and anatomic defects, in particular, cardiac anomalies, and the option of earlier diagnosis by chorionic villus sampling, if available. This policy updates the American College of Medical Genetics policy statement entitled Second Trimester Maternal Serum Screening for Fetal Open Neural Tube Defects and Aneuploidy (2004) and complements the sections of American College of Medical Genetic’s Standards and Guidelines for Clinical Genetics Laboratories entitled “Prenatal screening for Down syndrome that includes first trimester biochemistry and/or ultrasound measurements.” PMID:18197059

  19. Confronting the challenge of unsafe second-trimester abortion.

    Science.gov (United States)

    Harris, Lisa H; Grossman, Daniel

    2011-10-01

    Unsafe abortion accounts for approximately 13% of maternal deaths worldwide-roughly 47,000 deaths per year. Most deaths from unsafe abortion occur in low-resource countries. Second-trimester abortion carries a higher risk of morbidity and mortality compared with first-trimester abortion and, although the former comprises the minority of abortion procedures worldwide, it is responsible for the majority of serious complications and death where unsafe abortion is prevalent. Therefore, improving access to safe second-trimester abortion must be a priority in low-income regions of the world if the majority of deaths from unsafe abortion are to be prevented. In the present paper, we consider a variety of barriers to second-trimester care, including healthcare provider training and abortion stigma, which may lead to neglect of unmet need for second-trimester services. Copyright © 2011 International Journal of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  20. Effect of water storage on the translucency of silorane-based and dimethacrylate-based composite resins with fibres.

    Science.gov (United States)

    Ozakar Ilday, Nurcan; Celik, Neslihan; Bayindir, Yusuf Ziya; Seven, Nilgün

    2014-06-01

    The purposes of this study were (1) to determine the translucency of silorane and dimethacrylate-based composite resins and (2) to evaluate the effect of water storage and reinforcement with fibre on the translucency of composite resins. Two light-cured composite resins (A2 shade), Filtek Silorane (silorane-based composite) and Valux Plus (dimethacrylate-based composite), were used in this study. The first group was used as the control with no reinforcements, the second was reinforced with polyethylene (Ribbond THM) and the third was reinforced with a glass fibre (Everstick Net) for each composite resin. Colour measurements were measured against white and black backgrounds with a Shadepilot (Degu Dent Gmbh, Hanau, Germany) spectrophotometer and recorded under a D65 light source, which reflects daylight. CIELAB parameters of each specimen were recorded at baseline and at 24 h, 168 h and 504 h. Translucency of materials was calculated using the translucency parameter (TP) formula. Data were analyzed using repeated measures ANOVA and LSD post hoc tests (α=0.05). The highest baseline TP value was in the Valux Plus/non-fibre reinforced group (14.06±1) and the lowest in the Filtek Silorane/Ribond THM group (8.98±1.11). Repeated measures ANOVA revealed significant effects from the factors storage time, composite resin, composite resin×storage time and fibre×time (p=0.047; p=0.001; p=0.013; p=0.022, respectively). Within the limitations of the study, we concluded that inclusion of polyethylene and glass fibres did not alter the translucency of the different-based composite resins. The longest storage time resulted in the greatest change in translucency values of Filtek Silorane composite resins. Considering the translucencies of composites with different formulations in the selection of composite resins for aesthetic restorations is important in terms of obtaining optimal aesthetic outcomes. Copyright © 2014 Elsevier Ltd. All rights reserved.

  1. The Effect of Lithium Disilicate Ceramic Thickness and Translucency on Shear Bond Strength of Light-cured Resin Cement

    Directory of Open Access Journals (Sweden)

    Mohammad Javad Moghaddas

    2017-09-01

    Full Text Available Introduction: To achieve acceptable clinical performance, a ceramic veneer must be bonded to enamel by well-polymerized resin cement. Among different factors, thickness and translucency of the ceramic may affect the resin cement polymerization. Thus, the current study evaluated the effect of the thickness and translucency of lithium disilicate ceramic on light-cured resin cement bond strength to enamel. Methods: In this laboratory study, 208 sound bovine incisors were equally divided into 16 groups (n = 13. The lithium disilicate ceramic cubes in four thicknesses (0.4, 0.6, 0.8 and 1 mm with four translucencies (high and medium opaque, high and low translucent were fabricated and bonded to prepared enamel surfaces using a light-cured translucent resin cement according to manufacturer recommendations. After 5000 cycles of thermocycling, the bonded specimens were placed in a universal testing machine and loaded to the point of fracture. To determine the mode of failure, each sample was observed under a stereomicroscope. Data were recorded and analyzed by Shapiro-Wilk test and two-way analysis of variance (ANOVA. Results: The ceramic thickness and translucency could not significantly affect shear bond strength (SBS of resin cement to enamel (p = 0.17 and p = 0.097, respectively.  The Adhesive and ceramic cohesive failures were reported as the maximum and minimum mode of failure, respectively. Conclusion: The SBS of the light-cured resin cement bonding to enamel and lithium disilicate ceramic was not affected by the translucency of ceramics having a thickness of less than 1 mm.

  2. First-Trimester Exposure to Methylphenidate

    DEFF Research Database (Denmark)

    Pottegård, Anton; Hallas, Jesper; Andersen, Jon T

    2014-01-01

    OBJECTIVE: The use of methylphenidate to treat attention-deficit/hyperactivity disorder has risen dramatically in Western countries, and it is increasingly used by adults, including women of childbearing age. Very little is known about potential hazards of in utero exposure to methylphenidate. We...... conducted this study to estimate the risk of major congenital malformations following first-trimester in utero exposure to methylphenidate. METHOD: Data from 2005 to 2012 were extracted from the Danish National Patient Register, the Danish National Prescription Registry, the Medical Birth Registry...... pregnancies in the analysis. There was no statistically significant increase in major malformations (point prevalence ratio = 0.8; 95% CI, 0.3-1.8) or cardiac malformations (point prevalence ratio = 0.9; 95% CI, 0.2-3.0). Sensitivity analyses using different definitions of exposure or previous users...

  3. Sonographer's guide to mid-trimester anatomy (Morphology) scan

    International Nuclear Information System (INIS)

    Chumo, K.B.

    2006-01-01

    Prenatal ultrasound examination has been proven to be effective in the diagnosis of prenatal chromosomal abnormalities. the thickened nuchal fold, the first sign of downs syndrome (T21), was first described over 20 years ago. multiple sonographically identifiable markers have been described as associated with T21. other chromosomal abnormalities e.g. Trisomy 18, Trisomy 13 and triploidy have typical sonographic markers (signs) in low risk women usually require further investigation; however, patients at increased risk for aneuploidy due to increased maternal age and or abnormal serum screening may benefit from morphologic (anatomy) sonogram screening for Sonographic signs of chromosomal abnormalities

  4. Fracture strength of veneered translucent zirconium dioxide crowns with different porcelain thicknesses

    Science.gov (United States)

    Bakitian, Fahad; Seweryniak, Przemek; Papia, Evaggelia; Larsson, Christel; Vult von Steyern, Per

    2017-01-01

    Abstract Objective: To evaluate fracture strength of veneered translucent zirconium dioxide crowns designed with different porcelain layer thicknesses. Materials and Methods: Sixty crowns, divided into six groups of 10, were used in this study. Groups were divided according to different thicknesses of porcelain veneer on translucent zirconium dioxide cores of equal thickness (0.5 mm). Porcelain thicknesses were 2.5, 2.0, 1.0, 0.8, 0.5 and 0.3 mm. Crowns were artificially aged before loaded to fracture. Determination of fracture mode was performed using light microscope. Results: Group 1.0 mm showed significantly (p ≤ .05) highest fracture loads (mean 1540 N) in comparison with groups 2.5, 2.0 and 0.3 mm (mean 851, 910 and 1202 N). There was no significant difference (p>.05) in fracture loads among groups 1.0, 0.8 and 0.5 mm (mean 1540, 1313 and 1286 N). There were significantly (p ≤ .05) more complete fractures in group 0.3 mm compared to all other groups which presented mainly cohesive fractures. Conclusions: Translucent zirconium dioxide crowns can be veneered with minimal thickness layer of 0.5 mm porcelain without showing significantly reduced fracture strength compared to traditionally veneered (1.0–2.0 mm) crowns. Fracture strength of micro-veneered crowns with a layer of porcelain (0.3 mm) is lower than that of traditionally veneered crowns but still within range of what may be considered clinically sufficient. Porcelain layers of 2.0 mm or thicker should be used where expected loads are low only. PMID:29242815

  5. Translucency and masking ability of various composite resins at different thicknesses.

    Science.gov (United States)

    Darabi, Farideh; Radafshar, Golpar; Tavangar, Maryam; Davaloo, Reza; Khosravian, Aref; Mirfarhadi, Nastaran

    2014-09-01

    Optical properties of the composite resins, concerning their translucency and thickness, are affected by discolored tooth structure or inherent darkness of the oral cavity. This study aimed to compare the translucency parameter (TP) of five different composite resins in different thicknesses and to evaluate their masking ability in black backgrounds. Five brands of composite resins; Gradia (GC) and Crystalline (Confi-dental) in opaque A2 (OA2), Vit-l-escence (Ultradent) in opaque snow (OS), Herculite XRV (Kerr) and Opallis (FGM) in dentin A2 (DA2) shades were selected to enroll the study. Color coordinates of each composite were determined at 0.5, 1, and 1.5 mm thicknesses on a white backing, the backing of material itself and a black backing were calculated by using a spectrophotometer to evaluate the translucency parameter (TP) of the study materials. The masking ability was also calculated from the specimens on the material itself and on black backing. The values under 2 were estimated as imperceptible. One-way ANOVA, T-test and Tukey HSD were employed for statistical analysis. The masking ability values, recorded for the 1.5 mm-thick specimens, were in the range of imperceptible except for the Herculite. There was no difference in TP values of the materials at 1.5 mm thickness. Opaque snow shade of Vit-l-escence and opaque A2 shade of Gradia showed lower TP values in comparison with the other 1 and 0.5 mm-thick materials and this difference was statistically significant (pcomposite resins could not mask the black background color.

  6. Effect of coloring and sintering on the translucency and biaxial strength of monolithic zirconia.

    Science.gov (United States)

    Sen, Nazmiye; Sermet, Ibrahim Bülent; Cinar, Sevki

    2018-02-01

    The influences of coloring and sintering procedures on the optical and mechanical properties of monolithic zirconia have not been thoroughly investigated. The purpose of this in vitro study was to investigate the effects of the coloring procedure and of varying final sintering temperatures on the translucency parameter (TP) and biaxial flexural strength (BFS) of monolithic zirconia. Disk-shaped specimens (N=210) of 2 different monolithic zirconia brands (Vita YZ HT White [VYZa]; Vita YZ HT Color A2 [VYZb]; Prettau Zirkonzahn [PZ]; Prettau Anterior Zirkonzahn [PZA]) with a diameter of 15 mm and a thickness of 1.0 ±0.05 mm were prepared. Half of the specimens prepared from noncolored blocks (VYZa, PZ, and PZA) received coloring liquid application. Then, the specimens were divided into 3 subgroups (n=10) according to the final sintering temperatures (1350°C, 1450°C, and 1600°C). The TP was determined by using a reflection spectrophotometer, and the BFS was tested with the piston-on-3-ball method in a universal testing machine. Data were statistically analyzed by multivariate multiple regression and Bonferroni tests (α=.05). Significant differences were obtained among the groups based on the results of the TP and BFS (Papplication significantly decreased the TP of VYZa (sintered at 1350°C) but produced no significant effect on the groups PZ and PZA. Additionally, the coloring procedure had no significant effect on the BFS of tested materials (VYZa, PZ, and PZA) (P>.05). Increased sintering temperature leads to increased translucency with minimal impact on the BFS. The coloring procedure should be considered at the time of material selection to avoid possible reduction in translucency. Copyright © 2017 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  7. Effect of ultraviolet aging on translucency of resin-cemented ceramic veneers: an in vitro study.

    Science.gov (United States)

    Turgut, Sedanur; Bagis, Bora; Turkaslan, Suha S; Bagis, Yildirim Hakan

    2014-01-01

    The aim of this in vitro study was to evaluate the translucency of ceramic veneers cemented with light- or dual-cured resin cements after accelerated aging. A total of 392 specimens were made of shade A1 with 0.5- and 1.0-mm thickness. Light-cured RelyX Veneer and dual-cured Maxcem Elite and Variolink II resin cements were applied on the porcelain discs with a thickness of 0.1 mm. Translucency parameter (TP) values of the ceramic veneers after cementation and UV aging test were evaluated. Statistical analyses were done with ANOVA and Tukey's tests and paired sample t-test (p resin cements affected the TP values of 0.5-mm-thick ceramic, while RelyX Veneer Tr (TP = 11.15; p = 0.608), Variolink II Tr (TP = 10.98; p = 0.55), and Maxcem Clear (TP = 11.81; p = 0.702) did not affect the translucency of 1-mm-thick ceramics (TP = 11.38). The aging process affected TP values of both ceramics and cemented ceramics, as the TP values decreased after aging. Among the TP values of opaque shade resin cements, there were significant differences between the "ceramic," "ceramic + RelyX Veneer WO," "ceramic + Variolink II WO," and "ceramic + Maxcem WO" variables for both 0.5 and 1 mm thicknesses (p ceramic," "ceramic + RelyX Veneer Tr," "ceramic + Variolink II Tr," and "ceramic + Maxcem Clear" variables at 0.5 mm thickness, and there were no significant differences between "ceramic," "ceramic + RelyX Veneer Tr," and "ceramic + Variolink II Tr" variables after aging (p > 0.05). The TP of the same color of resin cements varied related to the type or brand. Aging caused both the ceramics and cemented ceramics to become more opaque. © 2013 by the American College of Prosthodontists.

  8. The efficacy of ultrasound-guided extracorporeal shockwave therapy in patients with cervical spondylosis and nuchal ligament calcification

    Directory of Open Access Journals (Sweden)

    Tz-Yan Lin

    2015-07-01

    Full Text Available We investigated the effects of extracorporeal shockwave therapy (ESWT on the rehabilitation of cervical spondylosis with nuchal ligament (NL calcification under X-ray and ultrasound guidance. Sixty patients with cervical spondylosis and calcification of NL were selected and randomly assigned to three groups: A, B, and C. Patients in Group A received rehabilitation with 20 minutes of hot packs and underwent 15 minutes of intermittent cervical traction three times/week for 6 weeks. Patients in Group B received the same rehabilitation as those in Group A and ESWT (2000 impulses, 0.27 mJ/mm2 over the calcified NL guided by X-ray image. Patients in Group C received the same treatment as those in Group B, but the ESWT was guided by musculoskeletal sonography. The therapeutic effects were evaluated by: changes in range of motion (ROM of the cervical spine including flexion, extension, lateral bending, and rotation; visual analog pain scale; and Neck Disability Index before and after treatment and at follow up 3 months later. We found a significant reduction in pain in each treated group after treatment and at follow up. However, patients in Groups B and C showed more improvements in ROM and neck pain relief after treatment and a decrease in Neck Disability Index. Furthermore, patients in Group C showed better cervical ROM at follow up than Group B. ESWT is an adjuvant treatment in the management of cervical spondylosis with calcification of NL and ultrasound-guided ESWT results in more functional improvements.

  9. The efficacy of ultrasound-guided extracorporeal shockwave therapy in patients with cervical spondylosis and nuchal ligament calcification.

    Science.gov (United States)

    Lin, Tz-Yan; Chen, Jing-Ting; Chen, Yu-Yu; Chen, Tien-Wen; Lee, Chia-Ling; Chen, Chia-Hsin; Huang, Mao-Hsiung

    2015-07-01

    We investigated the effects of extracorporeal shockwave therapy (ESWT) on the rehabilitation of cervical spondylosis with nuchal ligament (NL) calcification under X-ray and ultrasound guidance. Sixty patients with cervical spondylosis and calcification of NL were selected and randomly assigned to three groups: A, B, and C. Patients in Group A received rehabilitation with 20 minutes of hot packs and underwent 15 minutes of intermittent cervical traction three times/week for 6 weeks. Patients in Group B received the same rehabilitation as those in Group A and ESWT (2000 impulses, 0.27 mJ/mm(2)) over the calcified NL guided by X-ray image. Patients in Group C received the same treatment as those in Group B, but the ESWT was guided by musculoskeletal sonography. The therapeutic effects were evaluated by: changes in range of motion (ROM) of the cervical spine including flexion, extension, lateral bending, and rotation; visual analog pain scale; and Neck Disability Index before and after treatment and at follow up 3 months later. We found a significant reduction in pain in each treated group after treatment and at follow up. However, patients in Groups B and C showed more improvements in ROM and neck pain relief after treatment and a decrease in Neck Disability Index. Furthermore, patients in Group C showed better cervical ROM at follow up than Group B. ESWT is an adjuvant treatment in the management of cervical spondylosis with calcification of NL and ultrasound-guided ESWT results in more functional improvements. Copyright © 2015. Published by Elsevier Taiwan.

  10. Relative translucency of six all-ceramic systems. Part II: core and veneer materials.

    Science.gov (United States)

    Heffernan, Michael J; Aquilino, Steven A; Diaz-Arnold, Ana M; Haselton, Debra R; Stanford, Clark M; Vargas, Marcos A

    2002-07-01

    STATEMENT OF PROBLEM All-ceramic core materials with various strengthening compositions have a range of translucencies. It is unknown whether translucency differs when all-ceramic materials are fabricated similarly to the clinical restoration with a veneered core material. This study compared the translucency of 6 all-ceramic materials veneered and glazed at clinically appropriate thicknesses. Core specimens (n = 5 per group) of Empress dentin, Empress 2 dentin, In-Ceram Alumina, In-Ceram Spinell, In-Ceram Zirconia, and Procera AllCeram were fabricated as described in Part I of this study and veneered with their corresponding dentin porcelain to a final thickness of 1.47 +/- 0.01 mm. These specimens were compared with veneered Vitadur Alpha opaque dentin (as a standard), a clear glass disc (positive control), and a high-noble metal-ceramic alloy (Porc. 52 SF) veneered with Vitadur Omega dentin (negative control). Specimen reflectance was measured with an integrating sphere attached to a spectrophotometer across the visible spectrum (380 to 700 nm); 0-degree illumination and diffuse viewing geometry were used. Measurements were repeated after a glazing cycle. Contrast ratios were calculated from the luminous reflectance (Y) of the specimens with a black (Yb) and a white backing (Yw) to give Yb/Yw with CIE illuminant D65 and a 2-degree observer function (0.0 = transparent, 1.0 = opaque). One-way analysis of variance and Tukey's multiple-comparison test were used to analyze the data (P<.05). Significant differences in contrast ratios were found among the ceramic systems tested when they were veneered (P<.0001) and after the glazing cycle (P<.0001). Significant changes in contrast ratios (P<.0001) also were identified when the veneered specimens were glazed. Within the limitations of this study, a range of translucency was identified in the veneered all-ceramic systems tested. Such variability may affect their ability to match natural teeth. The glazing cycle resulted

  11. La Noche de la Ciudad Translúcida. /The night on the translucent nigth.

    Directory of Open Access Journals (Sweden)

    Florsheim, Shimrit

    2005-06-01

    Full Text Available Se presenta la innovación del Hormigón Translúcido, analizando sus posibilidades en arquitectura y urbanismo, además de mostrar sus ventajas en beneficio del ahorro energético y calidad de vida de los habitantes./The following article presents a creation never seen before: the invention of the translucent concrete. This article analyzes its contribution to Architecture and Urbanism of these days, considering its advantages related with the energy saving and the life quality of the citizens.

  12. La Noche de la Ciudad Translúcida. /The night on the translucent nigth.

    OpenAIRE

    Florsheim, Shimrit

    2005-01-01

    Se presenta la innovación del Hormigón Translúcido, analizando sus posibilidades en arquitectura y urbanismo, además de mostrar sus ventajas en beneficio del ahorro energético y calidad de vida de los habitantes./The following article presents a creation never seen before: the invention of the translucent concrete. This article analyzes its contribution to Architecture and Urbanism of these days, considering its advantages related with the energy saving and the life quality of the citizens.

  13. Ethical dimensions of first-trimester fetal aneuploidy screening.

    Science.gov (United States)

    Chervenak, Frank A; McCullough, Laurence B

    2014-03-01

    Noninvasive first-trimester fetal aneuploidy screening provides pregnant women with risk assessment information early in pregnancy. Noninvasive first-trimester aneuploidy screening includes imaging of the fetus and maternal serum analyte and assessment of fetal genetic material in the maternal circulation. The ethical challenges of noninvasive first-trimester fetal aneuploidy screening concern the physician's role in the informed consent process for risk assessment, the goal of which is to empower pregnant women to make informed decisions about noninvasive aneuploidy screening. This article provides physicians with an ethical framework for the professionally responsible management of these ethical challenges and for those related to emerging technologies.

  14. Switching between transparent and translucent states of a two-dimensional liquid crystal phase grating device with crossed interdigitated electrodes.

    Science.gov (United States)

    Choi, Tae-Hoon; Huh, Jae-Won; Woo, Jae-Hyeon; Kim, Jin-Hun; Jo, Young-Seo; Yoon, Tae-Hoon

    2017-05-15

    We report an electrically-switchable two-dimensional liquid crystal (LC) phase grating device for window display applications. The device consists of the top and bottom substrates with crossed interdigitated electrodes and vertically-aligned LCs sandwiched between the two substrates. The device, switchable between the transparent and translucent states by applying an electric field, can provide high haze by the strong diffraction effect thanks to a large spatial phase difference with little dependence on the azimuth angle. We found that the device has outstanding features, such as a low operating voltage, high transparency, and wide viewing angle characteristics in the transparent state and high haze in the translucent state. Moreover, we achieved submillisecond switching between transparent and translucent states by employing the overdrive scheme and a vertical trigger pulse.

  15. Prenatal Testing: MedlinePlus Health Topic

    Science.gov (United States)

    ... Chorionic villus sampling (Medical Encyclopedia) Also in Spanish Monitoring your baby before labor (Medical Encyclopedia) Also in Spanish Nuchal ... sampling - slideshow Fetal echocardiography Fetal-maternal erythrocyte ... your baby before labor Nuchal translucency test Percutaneous umbilical cord ...

  16. Monolithic translucent BaMgAl10O17:Eu2+ phosphors for laser-driven solid state lighting

    Directory of Open Access Journals (Sweden)

    Clayton Cozzan

    2016-10-01

    Full Text Available With high power light emitting diodes and laser diodes being explored for white light generation and visible light communication, thermally robust encapsulation schemes for color-converting inorganic phosphors are essential. In the current work, the canonical blue-emitting phosphor, high purity Eu-doped BaMgAl10O17, has been prepared using microwave-assisted heating (25 min and densified into translucent ceramic phosphor monoliths using spark plasma sintering (30 min. The resulting translucent ceramic monoliths convert UV laser light to blue light with the same efficiency as the starting powder and provide superior thermal management in comparison with silicone encapsulation.

  17. Assessment of Gestational Age in the Third Trimester of Pregnancy ...

    African Journals Online (AJOL)

    SFH) with ultrasonic measurement of biparietal diameter (BPD) and femur length (FL) in assessing gestational age in the third trimester of pregnancy. Subjects and Methods:Women carrying singleton uncomplicated pregnancies in the third ...

  18. First Observation of the Submillimeter Polarization Spectrum in a Translucent Molecular Cloud

    Science.gov (United States)

    Ashton, Peter C.; Ade, Peter A. R.; Angilè, Francesco E.; Benton, Steven J.; Devlin, Mark J.; Dober, Bradley; Fissel, Laura M.; Fukui, Yasuo; Galitzki, Nicholas; Gandilo, Natalie N.; Klein, Jeffrey; Korotkov, Andrei L.; Li, Zhi-Yun; Martin, Peter G.; Matthews, Tristan G.; Moncelsi, Lorenzo; Nakamura, Fumitaka; Netterfield, Calvin B.; Novak, Giles; Pascale, Enzo; Poidevin, Frédérick; Santos, Fabio P.; Savini, Giorgio; Scott, Douglas; Shariff, Jamil A.; Soler, Juan D.; Thomas, Nicholas E.; Tucker, Carole E.; Tucker, Gregory S.; Ward-Thompson, Derek

    2018-04-01

    Polarized emission from aligned dust is a crucial tool for studies of magnetism in the ISM, but a troublesome contaminant for studies of cosmic microwave background polarization. In each case, an understanding of the significance of the polarization signal requires well-calibrated physical models of dust grains. Despite decades of progress in theory and observation, polarized dust models remain largely underconstrained. During its 2012 flight, the balloon-borne telescope BLASTPol obtained simultaneous broadband polarimetric maps of a translucent molecular cloud at 250, 350, and 500 μm. Combining these data with polarimetry from the Planck 850 μm band, we have produced a submillimeter polarization spectrum, the first for a cloud of this type. We find the polarization degree to be largely constant across the four bands. This result introduces a new observable with the potential to place strong empirical constraints on ISM dust polarization models in a previously inaccessible density regime. Compared to models by Draine & Fraisse, our result disfavors two of their models for which all polarization arises due only to aligned silicate grains. By creating simple models for polarized emission in a translucent cloud, we verify that extinction within the cloud should have only a small effect on the polarization spectrum shape, compared to the diffuse ISM. Thus, we expect the measured polarization spectrum to be a valid check on diffuse ISM dust models. The general flatness of the observed polarization spectrum suggests a challenge to models where temperature and alignment degree are strongly correlated across major dust components.

  19. Effect of the amount of thickness reduction on color and translucency of dental monolithic zirconia ceramics.

    Science.gov (United States)

    Kim, Hee-Kyung; Kim, Sung-Hun; Lee, Jai-Bong; Han, Jung-Suk; Yeo, In-Sung; Ha, Seung-Ryong

    2016-02-01

    This study investigated the effect of amount of thickness reduction on color and translucency of dental monolithic zirconia ceramics. One-hundred sixty-five monolithic zirconia specimens (16.3 mm × 16.3 mm × 2.0 mm) were divided into 5 groups (Group I to V) according to the number of A2-coloring liquid applications. Each group was then divided into 11 subgroups by reducing the thickness up to 1.0 mm in 0.1-mm increments (Subgroup 0 to 10, n=3). Colors and spectral distributions were measured according to CIELAB on a reflection spectrophotometer. All measurements were performed on five different areas of each specimen. Color difference (ΔE(*) ab) and translucency parameter (TP) were calculated. Data were analyzed using one-way ANOVA and multiple comparison Scheffé test (α=.05). There were significant differences in CIE L(*) between Subgroup 0 and other subgroups in all groups. CIE a(*) increased (0.523.7) were obtained between Subgroup 0 and other subgroups. TP values generally increased as the thickness reduction increased in all groups (R(2)>0.89, Pmonolithic zirconia ceramics.

  20. Effects of surface treatments on the translucency, opalescence, and surface texture of dental monolithic zirconia ceramics.

    Science.gov (United States)

    Kim, Hee-Kyung; Kim, Sung-Hun; Lee, Jai-Bong; Ha, Seung-Ryong

    2016-06-01

    Surface polishing or glazing may increase the appearance of depth of monolithic zirconia restorations. The purpose of this in vitro study was to investigate the effects of surface treatments on the translucency, opalescence, and surface texture of dental monolithic zirconia ceramics. Forty-five monolithic zirconia specimens (16.3×16.4×2.0 mm) were divided into groups I to V, according to the number of colorings each received. Each group was then divided into 3 subgroups (n=3) according to the surface treatment: N=no treatment; P=polished; and G=glazed. CIElab color coordinates were obtained relative to D65 on a reflection spectrophotometer. The translucency parameter (TP) and opalescence parameter (OP) were calculated. One specimen per subgroups I and V was selected for evaluation of surface roughness (Ra) and was examined with scanning electron microscopy (SEM). Data were analyzed with 2-way ANOVA and pairwise comparisons (α=.05). Statistical powers were verified to evaluate results (α=.05). The interaction effects of surface treatments combined with the number of colorings were significant for TP, OP, and Ra (P.05), whereas glazing significantly decreased OP and Ra in most groups. SEM images demonstrated that surface treatments affected the surface texture of monolithic zirconia ceramics. Surface treatments combined with coloring strongly affect the surface texture of dental monolithic zirconia ceramics. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  1. [Aging of silorane- and methacrylate-based composite resins: effects on color and translucency].

    Science.gov (United States)

    Liu, Chang; Pan, Jie; Lin, Hong; Shen, Song

    2015-10-01

    To evaluate the color stability and translucency of silorane-based low shrinkage composite after in vitro aging procedures of thermal cycling and water storage respectively, and to compare with those of conventional methacrylate-based posterior composite. Three light-cured composite resins, dimethacrylate-based composite A (Filtek™ Z350), B (Filtek™ P60) and silorane-based composite C (Filtek™ P90), were tested in this study. Ten specimens (10 mm in diameter, 1 mm in height) of each composite were prepared. The ten specimens in each group were then divided into two subgroups (n = 5). One subgroup underwent thermal cycling [(5.0 ± 0.5)~(55.0 ± 1.0) °C, 10 000 cycles] and the other was stored in 37 C° distilled water for 180 days. With a spectrophotometer, the CIE L * a * b * parameters of the specimens were tested before and after artificial aging against white, medium grey and black backgrounds, respectively. △E, TP and △TP were calculated and data were analyzed using independent-samples t test and partial analysis (P composite showed color alteration above the clinically acceptable levels (△E > 3.3), and also showed higher △E with a statistically significant difference in comparison with the other composites (B and C) (P composite C showed more alteration compared with composite B (P composite underwent greater alteration with regard to color stability and translucency.

  2. Integrated Thermal-Energy Analysis of Innovative Translucent White Marble for Building Envelope Application

    Directory of Open Access Journals (Sweden)

    Federica Rosso

    2014-08-01

    Full Text Available Marble is a natural material, used in the construction field since antiquity. It has always been used to communicate monumentality and solidity. Nowadays new technologies permit marble to express new languages: particularly, translucent marble technology overturns the concept of solidity. The main issue to address is the lack of thermal-energy performance of such a thin stone layer as the only facade component. Conversely, Bianco Carrara and Statuario marbles, for instance, have intrinsic benefits as natural cool materials, due to their high solar reflectance and thermal emissivity. Thus, this paper analyzes the thermal-energy and environmental behavior of marble facade for a new designed building in New York City. An integrated analysis of the energy performance of the marble skin is performed through a preliminary experimental characterization, carried out for two different types of naturally white marble, for comparative purposes. Then, a dynamic simulation model of the building is developed to evaluate year-round benefits and drawbacks of the translucent marble envelope in terms of indoor thermal comfort and air-conditioning requirement. The analysis showed how the proposed marble facade is able to decrease the energy requirement for cooling up to 6%, demonstrating possible relevant perspectives for marble-based facades, even in energy-efficient buildings.

  3. High-resolution setup for measuring wavelength sensitivity of photoyellowing of translucent materials

    Energy Technology Data Exchange (ETDEWEB)

    Vaskuri, Anna, E-mail: anna.vaskuri@aalto.fi; Kärhä, Petri [Metrology Research Institute, Aalto University, P.O. Box 13000, FI-00076 Aalto (Finland); Heikkilä, Anu [R& D/Climate Research, Finnish Meteorological Institute, P.O. Box 503, FI-00101 Helsinki (Finland); Ikonen, Erkki [Metrology Research Institute, Aalto University, P.O. Box 13000, FI-00076 Aalto (Finland); MIKES Metrology, VTT Technical Research Centre of Finland Ltd., P.O. Box 1000, FI-02044 VTT (Finland)

    2015-10-15

    Polystyrene and many other materials turn yellow when exposed to ultraviolet (UV) radiation. All photodegradation mechanisms including photoyellowing are functions of the exposure wavelength, which can be described with an action spectrum. In this work, a new high-resolution transmittance measurement setup based on lasers has been developed for measuring color changes, such as the photoyellowing of translucent materials aged with a spectrograph. The measurement setup includes 14 power-stabilized laser lines between 325 nm and 933 nm wavelengths, of which one at a time is directed on to the aged sample. The power transmitted through the sample is measured with a silicon detector utilizing an integrating sphere. The sample is mounted on a high-resolution XY translation stage. Measurement at various locations aged with different wavelengths of exposure radiation gives the transmittance data required for acquiring the action spectrum. The combination of a UV spectrograph and the new high-resolution transmittance measurement setup enables a novel method for studying the UV-induced ageing of translucent materials with a spectral resolution of 3–8 nm, limited by the adjustable spectral bandwidth range of the spectrograph. These achievements form a significant improvement over earlier methods.

  4. Influence of surface sealant on the translucency of composite resin: effect of immersion time and immersion media

    Directory of Open Access Journals (Sweden)

    Patrícia Petromilli Nordi Sasso Garcia

    2008-06-01

    Full Text Available This study evaluated the effect of surface sealant on the translucency of composite resin immersed in different solutions. The study involved the following materials: Charisma, Fortify and coffee, Coca-Cola®, tea and artificial saliva as solutions. Sixty-four specimens (n = 8 were manufactured and immersed in artificial saliva at 37 ± 1 °C. Samples were immersed in the solutions for three times a day and re-immersed in artificial saliva until the translucency readings. The measurements were carried out at nine times: T1 - 24 hours after specimen preparation, T2 - 24 hours after immersion in the solutions, T3 - 48 hours and T4 to T9 - 7, 14, 21, 30, 60 and 90 days, respectively, after immersion. The translucency values were measured using a JOUAN device. The results were subjected to ANOVA and Tukey's test at 5%. The surface sealant was not able to protect the composite resin against staining, the coffee showed the strongest staining action, followed by tea and regarding immersion time, a significant alteration was noted in the translucency of composite resin after 21 days.

  5. Fourier Domain Iterative Approach to Optical Sectioning of 3d Translucent Objects for Ophthalmology Purposes

    Science.gov (United States)

    Razgulina, A. V.; Iroshnikov, N. G.; Larichev, A. V.; Romanenko, T. E.; Goncharov, A. S.

    2017-05-01

    In this paper we deal with the problem of optical sectioning. This is a post processing step while investigating of 3D translucent medical objects based on rapid refocusing of the imaging system by the adaptive optics technique. Each image, captured in focal plane, can be represented as the sum of in-focus true section and out-of-focus images of the neighboring sections of the depth that are undesirable in the subsequent reconstruction of 3D object. The problem of optical sectioning under consideration is to elaborate a robust approach capable of obtaining a stack of cross section images purified from such distortions. For a typical sectioning statement arising in ophthalmology we propose a local iterative method in Fourier spectral plane. Compared to the non-local constant parameter selection for the whole spectral domain, the method demonstrates both improved sectioning results and a good level of scalability when implemented on multi-core CPUs.

  6. The effects of different opacifiers on the translucency of experimental dental composite resins.

    Science.gov (United States)

    Haas, Karine; Azhar, Gulelala; Wood, Duncan J; Moharamzadeh, Keyvan; van Noort, Richard

    2017-08-01

    The aim of this study was to evaluate the effects of different opacifiers on the translucency of experimental dental composite-resins. Three metal oxides that are used as opacifiers were tested in this study: titanium oxide (TiO 2 ), aluminium oxide (Al 2 O 3 ) and zirconium oxide (ZrO 2 ). Experimental composite-resins were fabricated containing 25wt.% urethane dimethacrylate (UDMA)-based resin matrix and 75% total filler including different concentrations of metal oxides (0, 0.25, 0.5, 0.75 and 1wt.%) blended into silane treated barium-silicate filler. The specimens (15.5mm diameter and 1mm thickness) were light-cured and tested in the transmittance mode using a UV/VIS spectrophotometer at wavelengths from 380 to 700nm under a standard illuminant D65. The color differences (ΔE* ab) between different concentrations of opacifiers were also measured in transmittance mode based on their Lab values. Statistical analysis by ANOVA and Tukey's test showed a significant decrease (pcomposite-resins. There was a linear correlation between different concentrations of TiO 2 and Al 2 O 3 and total transmittance. Total transmittance was also found to be wavelength dependent. The color differences for the concentrations of 0-1wt.% of the opacifiers were above 1 ΔE* unit, with Al 2 O 3 showing the smallest color shift. The type and the amount of the opacifiers used in this study had a significant effect on the translucency of the experimental UDMA-based dental composite resins. The most effective opacifier was TiO 2 , followed by ZrO 2 and Al 2 O 3 in decreasing order, respectively. Copyright © 2017 The Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

  7. Software package to automate the design and production of translucent building structures made of pvc

    Directory of Open Access Journals (Sweden)

    Petrova Irina Yur’evna

    2016-08-01

    Full Text Available The article describes the features of the design and production of translucent building structures made of PVC. The analysis of the automation systems of this process currently existing on the market is carried out, their advantages and disadvantages are identified. Basing on this analysis, a set of requirements for automation systems for the design and production of translucent building structures made of PVC is formulated; the basic entities are involved in those business processes. The necessary functions for the main application and for dealers’ application are specified. The main application is based on technological platform 1C: Enterprise 8.2. The dealers’ module is .NET application and is developed with the use of Microsoft Visual Studio and Microsoft SQL Server because these software products have client versions free for end users (.NET Framework 4.0 Client Profile and Microsoft SQL Server 2008 Express. The features of the developed software complex implementation are described; the relevant charts are given. The scheme of system deployment and protocols of data exchange between 1C server, 1C client and dealer is presented. Also the functions supported by 1C module and .NET module are described. The article describes the content of class library developed for .NET module. The specification of integration of the two applications in a single software package is given. The features of the GUI organization are described; the corresponding screenshots are given. The possible ways of further development of the described software complex are presented and a conclusion about its competitiveness and expediency of new researches is made.

  8. Temperature Spectra of Interstellar Dust Grains Heated by Cosmic Rays. I. Translucent Clouds

    Science.gov (United States)

    Kalvāns, Juris

    2016-06-01

    Heating of whole interstellar dust grains by cosmic-ray (CR) particles affects the gas-grain chemistry in molecular clouds by promoting molecule desorption, diffusion, and chemical reactions on grain surfaces. The frequency of such heating, f T , s-1, determines how often a certain temperature T CR, K, is reached for grains hit by CR particles. This study aims to provide astrochemists with a comprehensive and updated data set on CR-induced whole-grain heating. We present calculations of f T and T CR spectra for bare olivine grains with radius a of 0.05, 0.1, and 0.2 μm and such grains covered with ice mantles of thickness 0.1a and 0.3a. Grain shape and structure effects are considered, as well as 30 CR elemental constituents with an updated energy spectrum corresponding to a translucent cloud with A V = 2 mag. Energy deposition by CRs in grain material was calculated with the srim program. We report full T CR spectra for all nine grain types and consider initial grain temperatures of 10 K and 20 K. We also provide frequencies for a range of minimum T CR values. The calculated data set can be simply and flexibly implemented in astrochemical models. The results show that, in the case of translucent clouds, the currently adopted rate for heating of whole grains to temperatures in excess of 70 K is underestimated by approximately two orders of magnitude in astrochemical numerical simulations. Additionally, grains are heated by CRs to modest temperatures (20-30 K) with intervals of a few years, which reduces the possibility of ice chemical explosions.

  9. Medical management of first trimester miscarriage according to ultrasonographic findings

    DEFF Research Database (Denmark)

    Vejborg, Thomas; Nilas, Lisbeth; Rørbye, Christina

    2007-01-01

    BACKGROUND: The efficacy of medical treatment of first trimester miscarriages may depend on the regimen used, the definition of success, clinical symptoms, and, possibly, on the ultrasonographic findings. Our primary aim was to assess if a single dose of misoprostol could reduce the number...... of surgical interventions in early pregnancy failure, and to compare efficacy in different ultrasonographically-defined subgroups. METHODS: A retrospective review of 355 consecutive patients treated for a first trimester miscarriage with a single dose of vaginal misoprostol (400 microg), followed by vaginal...... and 3 (43.6%; pmisoprostol reduced the number of surgical interventions. The success rates of medically-treated first trimester miscarriages varied according to the ultrasonographic definitions...

  10. Women's experiences after an induced second trimester abortion.

    Science.gov (United States)

    Mukkavaara, Iris; Öhrling, Kerstin; Lindberg, Inger

    2012-10-01

    to describe women's experiences of an abortion in the second trimester. qualitative design using semi-structured interviews. six women were interviewed after a second trimester abortion. the women were interviewed in person after they were discharged from the hospital. Interviews were recorded, transcribed, and then analysed using qualitative content analysis. four categories were identified: to consider and accept the decision; to lack understanding about the abortion procedure; to be in need of support and information; to have memories for life. Findings show that information and support during the whole abortion process is important. Women found it difficult to make the decision and going through abortion left memories for life. information and support is of great importance for women in this vulnerable situation. The need for further support points out the need to have follow-up contacts with women after an induced second trimester abortion. Copyright © 2011 Elsevier Ltd. All rights reserved.

  11. Successful laparoscopic cholecystectomy in the third trimester of pregnancy

    International Nuclear Information System (INIS)

    Meshikhes, Abdul-Waheed N.

    2008-01-01

    We report a case of a 35-year-old lady who presented in the third trimester of her pregnancy with signs, symptoms and radiological features of acute cholecystitis. She was initially treated conservatively but failed to respond well. Hence, laparoscopic cholecystectomy (LC) was performed successfully with good materno-fetal outcome. This article discusses the feasibility and safety of LC in the third trimester of pregnancy and the special precautions that are needed to guarantee the safety of materno-fetal well-being. (author)

  12. Detection of Spina Bifida by First Trimester Screening - Results of the Prospective Multicenter Berlin IT-Study.

    Science.gov (United States)

    Chen, Frank Chih-Kang; Gerhardt, Janine; Entezami, Michael; Chaoui, Rabih; Henrich, Wolfgang

    2017-04-01

    Purpose  To evaluate the potential of routine assessment of intracranial translucency (IT) and other posterior brain parameters in the early detection of open spina bifida during the 11 - 14 weeks screening examination. Materials and Methods  This prospective, multicenter longitudinal study was conducted with the participation of 20 certified DEGUM II or III experts in Berlin, Germany, between June 2010 and October 2013. All pregnant women undergoing a first trimester screening were included in the study and in every patient were the IT, brain stem (BS), cisterna magna (CM), BS to occipital bone distance (BSOB) and BS/BSOB ratio measured. All patients with continuing pregnancy underwent a second trimester scan. Our data was used to develop our own reference ranges. The primary outcome parameter was the presence of open spina bifida. Results  A total of 15 526 women with 16 164 fetuses were examined. Median of the IT was 2.1 mm, of the CM 1.6 mm, of the BS 2.7 mm, of the BSOB 5.5 mm, and of the BS/BSOB ratio 0.49. There were 11 cases with open spina bifida (incidence of 6.8/10 000). The detection rate was 100 % and in all cases of spina bifida, the anomaly was detected either at the first examination (n = 8) or considered suspicious and the lesion then detected a few weeks later (n = 3). Considering individual measurements, however, the detection rate was 18 % with the complete absence of the IT and 45 % with cut-off values. For the CM measurement, the detection rate was 64 % with the absence of the CM and 73 % with cut-off values. The other parameters proved not to be predictive of open spina bifida. Conclusion  In the hands of an expert, open spina bifida can be reliably diagnosed early in gestation during the 11 - 14 weeks screening. The measurement of different parameters of the posterior brain, especially the CM and the use of cut-off values are of tremendous benefit in achieving a high sensitivity in the

  13. Bidirectional reflectance study on dry, wet, and submerged particulate layers: effects of pore liquid refractive index and translucent particle concentrations.

    Science.gov (United States)

    Zhang, Hao; Voss, Kenneth J

    2006-12-01

    We performed extensive bidirectional reflectance measurements on dry, wet, and submerged particulate layers with various albedos to investigate the darkening effect caused by wetting with fluids. It was found that, in addition to the reduction of the refractive index contrast when there is a pore liquid (wetted), the concentration of translucent grains in a particulate layer and the surface roughness conditions of the individual grains make important contributions to the wetting-induced darkening effect. Reflectance measurements on glass-sediment mixtures confirmed that, as the concentration of translucent particles increases, the reflectance of the dry layers increases while that of the wetted layers decreases. Measurements indicate that neither the prediction made by the theory of Twomey et al. [Appl. Opt. 25, 431 (1986)] nor that of Lekner and Dorf [Appl. Opt. 27, 1278 (1988)] is sufficient.

  14. Fetal Ascites and Second Trimester Maternal Hepatitis C Virus Infection

    Directory of Open Access Journals (Sweden)

    Pei-Ying Ling

    2006-09-01

    Conclusion: Second trimester perinatal HCV infection with possible CMV coinfection associated with fetal ascites is a rare event. Fetal therapy resulting in a successful outcome has not been reported. Prompt fetal therapy with paracentesis in this case led to the delivery of a healthy term liveborn baby with anti-HCV seropositivity.

  15. Maternal weight gain in second and third trimesters and their ...

    African Journals Online (AJOL)

    Multiple linear regression analysis was used to determine the relative contributions of some selected maternal variables. (independent variables) to the infant's birth weight. (dependent variable). The selected maternal variables included age, height, weight, gestational period and weight gain at second and third trimesters.

  16. Medical versus surgical termination of the first trimester missed ...

    African Journals Online (AJOL)

    Alia A. Shuaib

    a Sana'a University, Faculty of Medicine, Obstetrics and Gynecology Department, Sanaa, Yemen b Thamar University, Obstetrics and Gynecology, Sheraton Street, Sanaa, Yemen. Received 1 April 2012; accepted 20 August 2012. Available online 29 September 2012. KEYWORDS. Medical termination of first trimester;.

  17. Characteristics of women booking for first and second trimester ...

    African Journals Online (AJOL)

    Characteristics of women booking for first and second trimester abortions at public sector clinics in Cape Town. STUDENT PAPER. Chelsea Morroni, MPH, MPhil. Jennifer Moodley, MB ChB, MMed (Public Health). Women's Health Research Unit, School of Public Health and Family Medicine, University of. Cape Town ...

  18. Are early first trimester weights valid proxies for preconception weight?

    Science.gov (United States)

    An accurate estimate of preconception weight is necessary for providing a gestational weight gain range based on the Institute of Medicine’s guidelines; however, an accurate and proximal preconception weight is not available for most women. We examined the validity of first trimester weights for est...

  19. Electrolytes concentration patterns in the three trimesters of pregnancy

    African Journals Online (AJOL)

    The physiologic adaptations of the pregnant woman involve the renal, cardiovascular and other systems of the body. This study aimed at evaluating electrolyte concentrations in the three trimesters of pregnancy. Blood samples were collected by aseptic techniques and the concentrations of electrolytes were determined ...

  20. The Determinants and Outcomes of Second Trimester Abortion at ...

    African Journals Online (AJOL)

    The mean time between expulsion of fetus and uterine evacuation was 4.31 hours. Complications noted included uterine perforation, hemorrhage, cervical or vaginal lacerations, shock and even death. Conclusion: The determinants of the second trimester abortion cases at the University Teaching Hospital are social, ...

  1. Taste preferences of west African dwarf ewes at different trimester ...

    African Journals Online (AJOL)

    Taste preferences of pregnant West African dwarf (WAD) ewes were studied at different trimester periods using the multiple choice preference test method. A total of twelve WAD ewes of average body weight of 15.96 ± 4.17 kg, divided into two groups (A and B) were used for the study. Six pregnant ewes (in group A) served ...

  2. Venous thrombosis during pregnancy: leg and trimester of presentation

    NARCIS (Netherlands)

    Ginsberg, J. S.; Brill-Edwards, P.; Burrows, R. F.; Bona, R.; Prandoni, P.; Büller, H. R.; Lensing, A.

    1992-01-01

    In order to determine the relative frequencies of left and right leg venous thrombosis during pregnancy and the frequencies of venous thrombosis during the three trimesters, a cohort study of 60 consecutive patients with a first episode of venous thrombosis during pregnancy was performed.

  3. Maternal weight gain in second and third trimesters and their ...

    African Journals Online (AJOL)

    Results from Pearson correlation analysis found a positive correlation (P<0.001) between birth weight and variables such as maternal age, gestational period, parity, weight gain in both second and third trimester, birth length and sex of an infant. Multiple regression analysis indicated that birth weight (dependent variable) ...

  4. Rupture of a previously scarred uterus during second trimester ...

    African Journals Online (AJOL)

    Misoprostol is useful in ripening the cervix prior to mid-trimester termination of pregnancy. It is particularly indicated in cases of missed abortions whether the uterus is scarred or not. The procedure is safe in the majority of cases. We present a case of uterine rupture during induction of labour with vaginal misoprostol for a ...

  5. Assessment of platelet profile of healthy volunteers in the trimesters ...

    African Journals Online (AJOL)

    Assessment of platelet profile of healthy volunteers in the trimesters of pregnancy in Benin City, Nigeria. ... Thus PDW compensates for these reductions and a lack of this compensatory increase may aggravate the effect of thrombocytopenia in pregnancy. Platelet Count, Plateletcrit, Mean Platelet Volume, Platelet ...

  6. Prediction of Gestational Diabetes by Measuring First Trimester ...

    African Journals Online (AJOL)

    Between 24 and 28 weeks' gestation random blood sugar and glucose challenge test were done. Positive cases were confirmed by 3 h glucose tolerance curve. Results: The results demonstrated an association between first trimester maternal serum uric acid concentration obesity and GDM. Approximately, 41.4% (60/145) ...

  7. Compromised chorionic villous vascularization in idiopathic second trimester fetal loss.

    Science.gov (United States)

    van Oppenraaij, R H F; Nik, H; Heathcote, L; McPartland, J L; Turner, M A; Quenby, S; Steegers, E A P; Exalto, N

    2010-08-01

    For normal fetal growth and development a well-developed chorionic villous vascularization is essential. The aim of this study is to investigate whether idiopathic second trimester fetal loss is associated with an underdeveloped chorionic villous vascularization. 38 placentas after late miscarriage, classified as idiopathic fetal loss (IFL, n=16) or as fetal loss due to intrauterine infection (IUI, n=22) were collected. After CD34 immunohistochemical staining the villous stromal area, number of villous vessels, vascular area and vascular area density (central, peripheral and total) were measured in randomly selected immature intermediate villi. The mean gestational age was 19+4 weeks for the IFL group and 20+6 weeks for the IUI group. After controlling for gestational age, we found no differences in fetal weight, placental weight, villous stromal area, number of vessels and central vascular features. The mean peripheral vascular area and peripheral vascular area density were, after adjusting for gestational age, reduced in the IFL group. Idiopathic second trimester fetal loss is associated with a reduced peripheral chorionic villous vascularization. We hypothesize that in these cases, placentation is already disturbed in first trimester of pregnancy, leading to a reduced materno-fetal interface in second trimester, thus to early postplacental fetal hypoxia and fetal death. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

  8. First trimester biochemistry in pregnancies conceived using assisted reproduction techniques

    DEFF Research Database (Denmark)

    Tabor, Ann; Ekelund, Charlotte; Nørgaard, Pernille

    Objective: To examine the effects of method of conception on first trimester PAPP-A and free beta-hCG and the dependency of gestational age at the time of sampling on these effects Methods: Data on more than 100 000 spontaneously conceived and on 6 859 pregnancies conceived by assisted reproducti...

  9. The effect of translucency of Y-TZP based all-ceramic crowns fabricated with difference substructure designs.

    Science.gov (United States)

    Kumagai, Naota; Hirayama, Hiroshi; Finkelman, Matthew D; Ishikawa-Nagai, Shigemi

    2013-08-01

    To analyse the effect of translucency of Y-TZP based all-ceramic crowns fabricated with different substructure thicknesses and extensions. The effect of restoration shading is also investigated. A maxillary right central incisal typodont tooth was prepared and a die was fabricated with Type IV stone after making impression. Horizontally and vertically reduced substructure extensions were designed at the facial cervical part with 0.3 mm and 0.5mm thick Lava Y-TZP. Each substructure was fabricated with two different shades, FS1 and FS7. A1 shade veneering porcelain was applied on FS1 shade Y-TZP substructures and D3 shade veneering porcelain was applied on FS7 shade Y-TZP substructures with lost wax and press ceramic technique. Ten specimens were fabricated for a total of 8 groups. The cervical and body colour of specimens were analysed with a spectrophotometer, after placing specimens on the two different coloured abutment teeth using translucent try-in cement. The data were obtained in CIELAB colour coordinates L*a*b*, and DE* through the test specimens over ND1 and ND8 shade abutments were calculated. At the cervical area, there was a significant difference on substructure extension (P crown shade could increase DE* at the body area. The translucency of a Y-TZP based all-ceramic crowns may influence its esthetic outcome when it is used on a discoloured abutment tooth. Clinicians should be aware of the effect of substructure design on the translucency of YTZP based all-ceramic crowns. 2012 Elsevier Ltd. All rights reserved.

  10. A highly conspicuous mineralized composite photonic architecture in the translucent shell of the blue-rayed limpet

    OpenAIRE

    Li, Ling; Kolle, Stefan; Weaver, James C.; Ortiz, Christine; Aizenberg, Joanna; Kolle, Mathias

    2014-01-01

    Many species rely on diverse selections of entirely organic photonic structures for the manipulation of light and the display of striking colours. Here we report the discovery of a mineralized hierarchical photonic architecture embedded within the translucent shell of the blue-rayed limpet Patella pellucida. The bright colour of the limpet’s stripes originates from light interference in a periodically layered zig-zag architecture of crystallographically co-oriented calcite lamellae. Beneath t...

  11. Capillary Water in Pericarp Enhances Hypoxic Condition during On-Tree Fruit Maturation That Induces Lignification and Triggers Translucent Flesh Disorder in Mangosteen (Garcinia mangostana L.

    Directory of Open Access Journals (Sweden)

    Sompoch Noichinda

    2017-01-01

    Full Text Available Translucent flesh of mangosteen normally occurs during fruit ripening. Rainfall, after water stress, enhanced on-tree mature green fruit to develop translucent flesh disorder more frequently. Thus, this research pursued the effect of applied water on translucent flesh disorder development. The on-tree mature green stage fruits were selected and wrapped with 3 layers of fabric sheet. After that, water was continuously dropped (flow rate of 0.6 ml/min on the wrapped sheet for 0, 1, and 2 days before picking. The results showed that duration time of water applying enhanced the increasing of water absorption significantly in peel. All of water-treated fruits ripened within 2-3 days after harvest and obviously had high lignin in secondary cell wall. It was hypothesized that lignification played an important role in hypoxia defense mechanism since the Na2CO3-SP fractionation extracted from alcohol insoluble residue (AIR of translucent flesh aril was higher than those of normal aril. This Na2CO3-SP reinforced the strength of cell wall complexity as well as displaying the translucency character. Hence, we concluded that the capillary water (took place in intercellular air space of fruit pericarp induced hypoxia tolerance mechanism that triggered translucent flesh disorder in mangosteen aril.

  12. DETECTION OF OH{sup +} IN TRANSLUCENT INTERSTELLAR CLOUDS: NEW ELECTRONIC TRANSITIONS AND PROBING THE PRIMARY COSMIC RAY IONIZATION RATE

    Energy Technology Data Exchange (ETDEWEB)

    Zhao, D.; Linnartz, H. [Sackler Laboratory for Astrophysics, Leiden Observatory, University of Leiden, PO Box 9513, 2300 RA Leiden (Netherlands); Galazutdinov, G. A. [Instituto de Astronomia, Universidad Catolica del Norte, Av. Angamos 0610, Antofagasta (Chile); Krełowski, J., E-mail: zhao@strw.leidenuniv.nl [Center for Astronomy, Nicholas Copernicus University, Gagarina 11, Pl-87-100 Toruń (Poland)

    2015-06-01

    We present the detection of rotationally resolved electronic transitions in the OH{sup +} A{sup 3}Π–X{sup 3}Σ{sup −} (0, 0) and (1, 0) bands toward CD-32 4348, HD 63804, HD 78344, and HD 80077. These four translucent clouds have been studied in a recent Very Large Telescope/Ultraviolet and Visual Echelle Spectrograph observational run. In total, seven absorption features of OH{sup +} are detected, and six of them are identified here for the first time, providing a precise tool to trace OH{sup +} in translucent interstellar clouds. An improved set of line positions and oscillator strengths is compiled to support our data interpretation. A dedicated analysis of the observed features in individual targets yields an accurate determination of OH{sup +} column densities. The results are applied to estimate the primary cosmic ray ionization rate in the investigated translucent clouds, which yields a typical value of ∼1.0 × 10{sup −16} s{sup −1}. In addition, following this work, two of the new interstellar features recently reported by Bhatt and Cami, at ∼3572.65 and 3346.96 Å, can be identified as OH{sup +} absorption lines now.

  13. Highly-translucent, strong and aging-resistant 3Y-TZP ceramics for dental restoration by grain boundary segregation.

    Science.gov (United States)

    Zhang, Fei; Vanmeensel, Kim; Batuk, Maria; Hadermann, Joke; Inokoshi, Masanao; Van Meerbeek, Bart; Naert, Ignace; Vleugels, Jef

    2015-04-01

    Latest trends in dental restorative ceramics involve the development of full-contour 3Y-TZP ceramics which can avoid chipping of veneering porcelains. Among the challenges are the low translucency and the hydrothermal stability of 3Y-TZP ceramics. In this work, different trivalent oxides (Al2O3, Sc2O3, Nd2O3 and La2O3) were selected to dope 3Y-TZP ceramics. Results show that dopant segregation was a key factor to design hydrothermally stable and high-translucent 3Y-TZP ceramics and the cation dopant radius could be used as a controlling parameter. A large trivalent dopant, oversized as compared to Zr(4+), exhibiting strong segregation at the ZrO2 grain boundary was preferred. The introduction of 0.2 mol% La2O3 in conventional 0.1-0.25 wt.% Al2O3-doped 3Y-TZP resulted in an excellent combination of high translucency and superior hydrothermal stability, while retaining excellent mechanical properties. Copyright © 2015 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

  14. Simulation of DNAPL migration in heterogeneous translucent porous media based on estimation of representative elementary volume

    Science.gov (United States)

    Wu, Ming; Wu, Jianfeng; Wu, Jichun

    2017-10-01

    When the dense nonaqueous phase liquid (DNAPL) comes into the subsurface environment, its migration behavior is crucially affected by the permeability and entry pressure of subsurface porous media. A prerequisite for accurately simulating DNAPL migration in aquifers is then the determination of the permeability, entry pressure and corresponding representative elementary volumes (REV) of porous media. However, the permeability, entry pressure and corresponding representative elementary volumes (REV) are hard to determine clearly. This study utilizes the light transmission micro-tomography (LTM) method to determine the permeability and entry pressure of two dimensional (2D) translucent porous media and integrates the LTM with a criterion of relative gradient error to quantify the corresponding REV of porous media. As a result, the DNAPL migration in porous media might be accurately simulated by discretizing the model at the REV dimension. To validate the quantification methods, an experiment of perchloroethylene (PCE) migration is conducted in a two-dimensional heterogeneous bench-scale aquifer cell. Based on the quantifications of permeability, entry pressure and REV scales of 2D porous media determined by the LTM and relative gradient error, different models with different sizes of discretization grid are used to simulate the PCE migration. It is shown that the model based on REV size agrees well with the experimental results over the entire migration period including calibration, verification and validation processes. This helps to better understand the microstructures of porous media and achieve accurately simulating DNAPL migration in aquifers based on the REV estimation.

  15. Dust models compatible with Planck intensity and polarization data in translucent lines of sight

    Science.gov (United States)

    Guillet, V.; Fanciullo, L.; Verstraete, L.; Boulanger, F.; Jones, A. P.; Miville-Deschênes, M.-A.; Ysard, N.; Levrier, F.; Alves, M.

    2018-02-01

    Context. Current dust models are challenged by the dust properties inferred from the analysis of Planck observations in total and polarized emission. Aims: We propose new dust models compatible with polarized and unpolarized data in extinction and emission for translucent lines of sight (0.5 Methods: We amended the DustEM tool to model polarized extinction and emission. We fit the spectral dependence of the mean extinction, polarized extinction, total and polarized spectral energy distributions (SEDs) with polycyclic aromatic hydrocarbons, astrosilicate and amorphous carbon (a-C) grains. The astrosilicate population is aligned along the magnetic field lines, while the a-C population may be aligned or not. Results: With their current optical properties, oblate astrosilicate grains are not emissive enough to reproduce the emission to extinction polarization ratio P353/pV derived with Planck data. Successful models are those using prolate astrosilicate grains with an elongation a/b = 3 and an inclusion of 20% porosity. The spectral dependence of the polarized SED is steeper in our models than in the data. Models perform slightly better when a-C grains are aligned. A small (6%) volume inclusion of a-C in the astrosilicate matrix removes the need for porosity and perfect grain alignment, and improves the fit to the polarized SED. Conclusions: Dust models based on astrosilicates can be reconciled with data by adapting the shape of grains and adding inclusions of porosity or a-C in the astrosilicate matrix.

  16. Determination of the solar transmittance for the translucent shutter with PCM in liquid and solid state

    Science.gov (United States)

    Komerska, Anna; Ksionek, Dariusz; Rosiński, Marian

    2017-11-01

    This article presents results of the energy performance of an external translucent shading component integrated with a phase change material. A proposed technology is able to accumulate considerable amounts of energy in the latent heat by absorbing solar energy. Due to selective optical properties, much of the visible light is still transmitted through the facade. Experimental measurements were carried out in a laboratory set-up - testing thermal chamber, located in the Faculty of Building Services, Hydro and Environmental Engineering at Warsaw University of Technology. The main result of the experimental study was the evaluation of the average solar transmittance in the whole measured spectrum, as well as in the infrared and visible light. Since the shift in optical properties was observed when the material was undergoing a phase transition, the average spectral transmittances were measured for different states of matter of the PCM material. The tested shutter showed abilities to reduce and modulate daylight and solar heat gains in the indoor environment, which could contribute to considerable energy savings.

  17. Effect of translucence of engineering ceramics on heat transfer in diesel engines. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Wahiduzzaman, S.; Morel, T. [Integral Technologies, Inc., Westmont, IL (United States)

    1992-04-01

    This report describes the experimental portion of a broader study undertaken to assess the effects of translucence of ceramic materials used as thermal barrier coatings in diesel engines. In an earlier analytical work a parametric study was performed, varying several radiative properties over ranges typical of engineering ceramics, thereby identifying the most important radiative properties and their impact on in-cylinder heat transfer. In the current study these properties were experimentally determined for several specific zirconia coatings considered for thermal barrier applications in diesel engines. The methodology of this study involved formulation of a model capable of describing radiative transfer through a semitransparent medium as a function of three independent model parameters, ie, absorption coefficient, scattering coefficient and refractive index. For the zirconia-based ceramics investigated in this study, it was concluded that for usual coating thicknesses (1.5--2.5 mm) these ceramics are optically thick and hence, are effective as radiative heat transfer barriers. These ceramics possess high scattering coefficients and low absorption coefficients causing them to be highly reflective (60-80%) in the spectral region where thermal radiation is important. The performance of the investigated ceramics and the mechanism of heat transfer were found to depend on surface condition, specifically on soot deposition. Thus, to insure the optimum thermal barrier operation for either clean or heavily sooted surfaces, a ceramic material with high scattering coefficient provides the best choice.

  18. Effect of translucence of engineering ceramics on heat transfer in diesel engines

    Energy Technology Data Exchange (ETDEWEB)

    Wahiduzzaman, S.; Morel, T. (Integral Technologies, Inc., Westmont, IL (United States))

    1992-04-01

    This report describes the experimental portion of a broader study undertaken to assess the effects of translucence of ceramic materials used as thermal barrier coatings in diesel engines. In an earlier analytical work a parametric study was performed, varying several radiative properties over ranges typical of engineering ceramics, thereby identifying the most important radiative properties and their impact on in-cylinder heat transfer. In the current study these properties were experimentally determined for several specific zirconia coatings considered for thermal barrier applications in diesel engines. The methodology of this study involved formulation of a model capable of describing radiative transfer through a semitransparent medium as a function of three independent model parameters, ie, absorption coefficient, scattering coefficient and refractive index. For the zirconia-based ceramics investigated in this study, it was concluded that for usual coating thicknesses (1.5--2.5 mm) these ceramics are optically thick and hence, are effective as radiative heat transfer barriers. These ceramics possess high scattering coefficients and low absorption coefficients causing them to be highly reflective (60-80%) in the spectral region where thermal radiation is important. The performance of the investigated ceramics and the mechanism of heat transfer were found to depend on surface condition, specifically on soot deposition. Thus, to insure the optimum thermal barrier operation for either clean or heavily sooted surfaces, a ceramic material with high scattering coefficient provides the best choice.

  19. Determination of the solar transmittance for the translucent shutter with PCM in liquid and solid state

    Directory of Open Access Journals (Sweden)

    Komerska Anna

    2017-01-01

    Full Text Available This article presents results of the energy performance of an external translucent shading component integrated with a phase change material. A proposed technology is able to accumulate considerable amounts of energy in the latent heat by absorbing solar energy. Due to selective optical properties, much of the visible light is still transmitted through the facade. Experimental measurements were carried out in a laboratory set–up – testing thermal chamber, located in the Faculty of Building Services, Hydro and Environmental Engineering at Warsaw University of Technology. The main result of the experimental study was the evaluation of the average solar transmittance in the whole measured spectrum, as well as in the infrared and visible light. Since the shift in optical properties was observed when the material was undergoing a phase transition, the average spectral transmittances were measured for different states of matter of the PCM material. The tested shutter showed abilities to reduce and modulate daylight and solar heat gains in the indoor environment, which could contribute to considerable energy savings.

  20. Importance of renal abnormalities first identified in the third trimester after normal findings on a detailed second-trimester structural fetal survey.

    Science.gov (United States)

    Shipp, Thomas D; Nguyen, Hiep T; Bromley, Bryann; Lyons, Jennifer G; Benacerraf, Beryl R

    2011-11-01

    The purpose of this study was to evaluate the importance of renal abnormalities first identified in the third trimester of pregnancy after normal findings on a detailed second-trimester structural fetal survey. Between March 1, 2007, and August 1, 2009, all patients having a sonographic examination in the third trimester who previously had normal findings on a second-trimester detailed structural fetal survey were retrospectively identified. Fetal renal abnormalities first detected in the third trimester and not seen during the second-trimester survey were tabulated. Neonatal follow-up was obtained for those with sonographic abnormalities. Overall, 4170 patients had third-trimester scans after normal findings on a detailed second-trimester survey. A new renal abnormality was detected in 77 (1.8%) of these third-trimester scans. Detailed postnatal imaging follow-up was available in 49 of 77 (63.6%), of which 44 (89.8%) had prenatal hydronephosis. Of these, 9 of 44 (20.5%) had reflux; 14 of 44 (31.8%) had normal findings or had hydronephosis that resolved on follow-up sonography after birth; and the rest had hydronephosis (13 of 44 [29.5%]), ureterovesical junction obstruction (3 of 44 [6.8%]), or ureteropelvic junction obstruction (5 of 44 [11.4%]). The other 5 fetuses with nonhydronephrotic renal abnormalities had pelvic kidneys (3) and unilateral renal agenesis (2). Two of those with reflux (22.2%) required surgery, and 1 of those with ureterovesical junction obstruction (33.3%) required surgery. Most renal abnormalities first identified in the third trimester after normal findings on a detailed second-trimester structural fetal survey were hydronephrosis, of which approximately one-third resolved after birth. Among the remaining neonates with persistent hydronephrosis, almost one-third had reflux that was not detected on the second-trimester anatomy scan.

  1. Medical management of first trimester miscarriage according to ultrasonographic findings

    DEFF Research Database (Denmark)

    Vejborg, Thomas; Nilas, Lisbeth; Rørbye, Christina

    2007-01-01

    BACKGROUND: The efficacy of medical treatment of first trimester miscarriages may depend on the regimen used, the definition of success, clinical symptoms, and, possibly, on the ultrasonographic findings. Our primary aim was to assess if a single dose of misoprostol could reduce the number...... of surgical interventions in early pregnancy failure, and to compare efficacy in different ultrasonographically-defined subgroups. METHODS: A retrospective review of 355 consecutive patients treated for a first trimester miscarriage with a single dose of vaginal misoprostol (400 microg), followed by vaginal...... ultrasonography after either 1, 2 or 3 days. Treatment was successful if a complete abortion was diagnosed at follow-up. The women were divided into 4 ultrasonographically-defined groups: missed abortion with a crown rump length (CRL)>or=6 mm (Group A1) or CRL

  2. HELLP kan ses i andet trimester ved antifosfolipidsyndrom

    DEFF Research Database (Denmark)

    Madsen, Bjørn Stæhr; Havelund, Troels

    2011-01-01

    The syndrome of haemolysis, elevated liver enzymes and low platelets (HELLP) is estimated to occur in 0.01-0.2% of pregnancies and is considered a severe form of preeclampsia. It is associated with considerable risk of maternal and foetal mortality. HELLP syndrome associated with antiphospholipid...... syndrome is known to occur early in the pregnancy. We report a case of severe HELLP syndrome complicated by multiple hepatic infarctions and portal vein thrombosis in the second trimester in a patient with antiphospholipid syndrome....

  3. Conjoined twins detected in the first trimester: A review

    Directory of Open Access Journals (Sweden)

    Chih-Ping Chen

    2011-12-01

    Full Text Available Conjoined twinning occurs in 1 in 100 sets of monozygotic twins, 1 in 50,000 gestations or 1 in 250,000 live births. With the advent of ultrasound technology, prenatal diagnosis of conjoined twins is possible. This article provides a comprehensive review of conjoined twins detected in the first trimester including fetal gender, maternal age, parity, types of fusion, related ultrasound abnormalities, perinatal outcome and association with assisted reproduction.

  4. First-trimester prenatal diagnosis of Tay-Sachs disease.

    OpenAIRE

    Grabowski, G A; Kruse, J R; Goldberg, J D; Chockkalingam, K; Gordon, R E; Blakemore, K J; Mahoney, M J; Desnick, R J

    1984-01-01

    The prenatal diagnosis of Tay-Sachs disease was made in two at-risk fetuses by the analysis of chorionic villi obtained at 9 and 11 menstrual weeks, respectively. The diagnoses were based on the absence of beta-hexosaminidase A activity as determined by: (1) specific enzyme assays, (2) anion-exchange chromatography, and (3) cellulose acetate gel electrophoresis. The enzymatic diagnoses were confirmed on fetal tissue as well as by ultrastructural demonstration of the first-trimester fetal neur...

  5. Radiative Transfer in a Translucent Cloud Illuminated by an Extended Background Source

    Energy Technology Data Exchange (ETDEWEB)

    Biganzoli, Davide [Università degli Studi dell’Insubria Dept. of Science and High Technology Via Valleggio, 11, I-22100 Como (Italy); Potenza, Marco A. C. [Universitá degli Studi di Milano Dept. of Physics Via Celoria 16, I-20133 Milano (Italy); Robberto, Massimo, E-mail: robberto@stsci.edu [Space Telescope Science Institute Baltimore, MD 21218 (United States)

    2017-05-01

    We discuss the radiative transfer theory for translucent clouds illuminated by an extended background source. First, we derive a rigorous solution based on the assumption that multiple scatterings produce an isotropic flux. Then we derive a more manageable analytic approximation showing that it nicely matches the results of the rigorous approach. To validate our model, we compare our predictions with accurate laboratory measurements for various types of well-characterized grains, including purely dielectric and strongly absorbing materials representative of astronomical icy and metallic grains, respectively, finding excellent agreement without the need to add free parameters. We use our model to explore the behavior of an astrophysical cloud illuminated by a diffuse source with dust grains having parameters typical of the classic ISM grains of Draine and Lee and protoplanetary disks, with an application to the dark silhouette disk 114–426 in Orion Nebula. We find that the scattering term modifies the transmitted radiation, both in terms of intensity (extinction) and shape (reddening) of the spectral distribution. In particular, for small optical thickness, our results show that scattering makes reddening almost negligible at visible wavelengths. Once the optical thickness increases enough and the probability of scattering events becomes close to or larger than 1, reddening becomes present but is appreciably modified with respect to the standard expression for line-of-sight absorption. Moreover, variations of the grain refractive index, in particular the amount of absorption, also play an important role in changing the shape of the spectral transmission curve, with dielectric grains showing the minimum amount of reddening.

  6. Radiative Transfer in a Translucent Cloud Illuminated by an Extended Background Source

    Science.gov (United States)

    Biganzoli, Davide; Potenza, Marco A. C.; Robberto, Massimo

    2017-05-01

    We discuss the radiative transfer theory for translucent clouds illuminated by an extended background source. First, we derive a rigorous solution based on the assumption that multiple scatterings produce an isotropic flux. Then we derive a more manageable analytic approximation showing that it nicely matches the results of the rigorous approach. To validate our model, we compare our predictions with accurate laboratory measurements for various types of well-characterized grains, including purely dielectric and strongly absorbing materials representative of astronomical icy and metallic grains, respectively, finding excellent agreement without the need to add free parameters. We use our model to explore the behavior of an astrophysical cloud illuminated by a diffuse source with dust grains having parameters typical of the classic ISM grains of Draine & Lee and protoplanetary disks, with an application to the dark silhouette disk 114-426 in Orion Nebula. We find that the scattering term modifies the transmitted radiation, both in terms of intensity (extinction) and shape (reddening) of the spectral distribution. In particular, for small optical thickness, our results show that scattering makes reddening almost negligible at visible wavelengths. Once the optical thickness increases enough and the probability of scattering events becomes close to or larger than 1, reddening becomes present but is appreciably modified with respect to the standard expression for line-of-sight absorption. Moreover, variations of the grain refractive index, in particular the amount of absorption, also play an important role in changing the shape of the spectral transmission curve, with dielectric grains showing the minimum amount of reddening.

  7. Relative translucency of six all-ceramic systems. Part I: core materials.

    Science.gov (United States)

    Heffernan, Michael J; Aquilino, Steven A; Diaz-Arnold, Ana M; Haselton, Debra R; Stanford, Clark M; Vargas, Marcos A

    2002-07-01

    All-ceramic restorations have been advocated for superior esthetics. Various materials have been used to improve ceramic core strength, but it is unclear whether they affect the opacity of all-ceramic systems. This study compared the translucency of 6 all-ceramic system core materials at clinically appropriate thicknesses. Disc specimens 13 mm in diameter and 0.49 +/- 0.01 mm in thickness were fabricated from the following materials (n = 5 per group): IPS Empress dentin, IPS Empress 2 dentin, In-Ceram Alumina core, In-Ceram Spinell core, In-Ceram Zirconia core, and Procera AllCeram core. Empress and Empress 2 dentin specimens also were fabricated and tested at a thickness of 0.77 +/- 0.02 mm (the manufacturer's recommended core thickness is 0.8 mm). A high-noble metal-ceramic alloy (Porc. 52 SF) served as the control, and Vitadur Alpha opaque dentin was used as a standard. Sample reflectance (ratio of the intensity of reflected light to that of the incident light) was measured with an integrating sphere attached to a spectrophotometer across the visible spectrum (380 to 700 nm); 0-degree illumination and diffuse viewing geometry were used. Contrast ratios were calculated from the luminous reflectance (Y) of the specimens with a black (Yb) and a white (Yw) backing to give Yb/Yw with CIE illuminant D65 and a 2-degree observer function (0.0 = transparent, 1.0 = opaque). One-way analysis of variance and Tukey's multiple-comparison test were used to analyze the data (P In-Ceram Spinell > Empress, Procera, Empress 2 > In-Ceram Alumina > In-Ceram Zirconia, 52 SF alloy.

  8. [Cholestasis and listeriosis in the third trimester of pregnancy].

    Science.gov (United States)

    Martínez-Montero, I; Segura Ortega, V; Martínez Jiménez, L; García Jiménez, A; Unzetabarrenetxea Barrenetxea, O; Pérez Rodríguez, A F

    2013-01-01

    Listeriosis is an infection produced by Listeria monocytogenes. It is infrequent and affects people at extreme ages, pregnant women, immunocompromised people and, occasionally, healthy people. Its incidence has increased in recent years and shows a certain tendency to seasonality, increasing in summer. It can appear sporadically or as outbreaks. In pregnant women the infection is most frequently produced in the third trimester and the symptoms are usually light. Nonetheless, the infection of the fetus is severe, and can produce miscarriages, fetal deaths, corioamnionitis and premature births with the newborn infected, manifested in the form of granulomatosis infantiseptica with abscesses and scattered granulomas or at a later stage , as meningitis or sepsis. Intrahepatic cholestasis is a reversible form of cholestasis, its cause is unknown, it is specific to pregnancy and is more frequent in multiparous women, in the third trimester and rarely before the 26th week. It disappears following childbirth and is the second cause of jaundice in pregnancy, after hepatitis. The diagnosis of cholestasis is basically clinical. It appears as palmoplantar pruritus but can also produce nausea, vomiting and abdominal discomfort localized in the right hypochondrium. Given that listeriosis and cholestasis can have a shared symptomology, the possibility of listeriosis must be borne in mind in order for early implementation of the mechanisms of diagnostic confirmation (cultivation of sterile fluids or tissues: blood, neonatal CSF, amniotic liquid or placenta) and specific treatment. We present a case of cholestasis and listeriosis in the third trimester with a good maternofetal result.

  9. First-trimester maternal gestational infection and cycloid psychosis.

    Science.gov (United States)

    Stöber, G; Kocher, I; Franzek, E; Beckmann, H

    1997-11-01

    Using a structured interview, the mothers of patients with cycloid psychosis, manic depression and controls (40 mothers in each case) were investigated in order to assess the occurrence of maternal gestational infection and other obstetric complications during pregnancy with the affected child. The cycloid psychoses with low heritability and a good long-term prognosis were found to be significantly associated with first-trimester respiratory infection (i.e. influenza and febrile cold). Furthermore, maternal infection seems to predict an early onset in cycloids. In manic depression, we failed to identify a significant link with maternal gestational infection or other obstetric complications. These findings are discussed in the light of our previous reports of an excess of maternal gestational infections during the second trimester in chronic schizophrenics. Our results suggest that the exogenously induced disturbances of fetal brain maturation during the first trimester of gestation caused by maternal respiratory infection via live virus or disturbed maternal immune response are involved in the aetiology of cycloid psychoses.

  10. Screening performance for trisomy 21 comparing first trimester combined screening and a first trimester contingent screening protocol including ductus venosus and tricuspid flow

    DEFF Research Database (Denmark)

    Ekelund, C K; Petersen, O B; Sundberg, K

    2012-01-01

    To compare the standard first trimester combined risk assessment for trisomy 21 with a contingent screening protocol including tricuspid flow and ductus venosus flow.......To compare the standard first trimester combined risk assessment for trisomy 21 with a contingent screening protocol including tricuspid flow and ductus venosus flow....

  11. Reduced translucency and the addition of black patterns increase the catch of the greenhouse whitefly, Trialeurodes vaporariorum, on yellow sticky traps.

    Directory of Open Access Journals (Sweden)

    Clare Sampson

    Full Text Available The greenhouse whitefly Trialeurodes vaporariorum (Westwood (Hemiptera: Aleyrodidae is a pest of a wide range of vegetable and ornamental crops in greenhouses around the world. Yellow sticky traps are highly attractive to flying adults and so are frequently used to monitor the pest. Our aim was to test whether changes in trap translucency or the addition of printed black patterns could increase the catch on yellow sticky traps in greenhouses. Field trials were carried out in commercial crops of strawberry and tomato under glass over three years. Reduced trap translucency increased trap catches by a factor of 1.5 to 7.0 and the catch increased significantly for both females and males. Spectrometer measurements showed that the increased catch was consistent with an increased landing stimulus from a colour opponency mechanism i.e. the ratio of energy from 500-640 nm to the energy from 300-500 nm. Printed black patterns increased trap catches on specific types of trap, by a factor of 1.4 to 2.3, and the catch increased significantly for both females and males. The patterns increased trap catch on moderately translucent traps, but decreased trap catch on less translucent traps. The evidence points to a contrast/edge effect of pattern, but laboratory experiments are needed to clarify this. Exploitation of these translucency and pattern effects could improve the efficacy of yellow traps for monitoring and mass trapping in crops.

  12. Reduced translucency and the addition of black patterns increase the catch of the greenhouse whitefly, Trialeurodes vaporariorum, on yellow sticky traps.

    Science.gov (United States)

    Sampson, Clare; Covaci, Anca D; Hamilton, James G C; Hassan, Nayem; Al-Zaidi, Shakir; Kirk, William D J

    2018-01-01

    The greenhouse whitefly Trialeurodes vaporariorum (Westwood) (Hemiptera: Aleyrodidae) is a pest of a wide range of vegetable and ornamental crops in greenhouses around the world. Yellow sticky traps are highly attractive to flying adults and so are frequently used to monitor the pest. Our aim was to test whether changes in trap translucency or the addition of printed black patterns could increase the catch on yellow sticky traps in greenhouses. Field trials were carried out in commercial crops of strawberry and tomato under glass over three years. Reduced trap translucency increased trap catches by a factor of 1.5 to 7.0 and the catch increased significantly for both females and males. Spectrometer measurements showed that the increased catch was consistent with an increased landing stimulus from a colour opponency mechanism i.e. the ratio of energy from 500-640 nm to the energy from 300-500 nm. Printed black patterns increased trap catches on specific types of trap, by a factor of 1.4 to 2.3, and the catch increased significantly for both females and males. The patterns increased trap catch on moderately translucent traps, but decreased trap catch on less translucent traps. The evidence points to a contrast/edge effect of pattern, but laboratory experiments are needed to clarify this. Exploitation of these translucency and pattern effects could improve the efficacy of yellow traps for monitoring and mass trapping in crops.

  13. Effect of priming agents on shear bond strengths of resin-based luting agents to a translucent zirconia material.

    Science.gov (United States)

    Yagawa, Shogo; Komine, Futoshi; Fushiki, Ryosuke; Kubochi, Kei; Kimura, Fumiaki; Matsumura, Hideo

    2017-09-19

    The purpose of the present study was to evaluate the effect of priming agents and artificial aging with thermocycling on shear bond strengths of two resin-based luting agents to a translucent zirconia material. A total of 308 pairs of translucent zirconia disk specimens were divided into seven treatment groups: Alloy Primer (ALP), Clearfil Ceramic Primer Plus (CCP), Meta Fast Bonding Liner (MFB), MR. bond (MRB), Super-Bond PZ Primer Liquid B (PZB), V-Primer (VPR), and an unprimed group (UP). The specimens in each group were bonded with Panavia V5 Universal (UNI) and Opaque shade (OPA). Shear bond strengths (n=11 each) were tested before and after 5000 thermocycles. The data were analyzed with the Kruskal-Wallis test and the Steel-Dwass test. For both 0 and 5000 thermocycles, the ALP (47.8 and 41.5MPa, respectively) and CCP (45.8 and 42.3MPa, respectively) groups showed significantly higher bond strengths than other groups in the UNI luting agent. For the OPA luting agent, CCP group (45.8MPa) exhibited the highest pre-thermocycling bond strength in all groups. The ALP (32.4MPa) and CCP (36.5MPa) groups had significantly higher post-thermocycling shear bond strengths than other groups. In several groups, the shear bond strengths of the UNI luting agent were significantly higher than those of the OPA luting agent before and after thermocycling. Application of priming agents containing hydrophobic phosphate monomer (MDP) yielded the durable bond strengths of resin-based luting agents to a translucent zirconia material. Copyright © 2017 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.

  14. A comparison of intravaginal misoprostol with sublingual misoprostol for second trimester medical termination of pregnancy

    OpenAIRE

    Ankita Pandey; Sarmila Kundu; Prasad Yeshwant Deshmukh

    2015-01-01

    Background: Second trimester abortions generally account for less number of patients as compared to first trimester abortions as patients generally come earlier as soon as pregnancy is recognized but now days due to advent of USG many cases of fetal anomaly are detected earlier accounting for increasing number of cases of second trimester. Methods: Present study was conducted among patients with pregnancy between 13-20 weeks of period of gestation (to be randomly assigned) after getting a...

  15. 2014 First-trimester ultrasound forum from the Korean Society of Ultrasound in Obstetrics and Gynecology.

    Science.gov (United States)

    Oh, Soo-Young; Hong, Joon Seok; Seol, Hyun-Joo; Hwang, Han Sung; Park, Hyun Soo; Kim, Kunwoo; Ko, Hyun Sun; Kwak, Dong-Wook; Kim, Moon Young; Park, Mi Hye; Oh, Min Jeong; Park, Joong Shin; Kim, Sa Jin

    2015-01-01

    A first-trimester ultrasound scan has become an essential part of antenatal care. The Korean Society of Ultrasound in Obstetrics and Gynecology held a first-trimester ultrasound forum on April 5, 2014. The forum aimed to present an updated review of the literature on the topic of first-trimester ultrasound in specific lectures and to host a panel discussion on several important issues regarding first-trimester scans. The forum provided evidence- and consensus-based best practice patterns for obstetricians in Korea. Here, we report the review and checklists presented from the forum.

  16. Dating of Pregnancy in First versus Second Trimester in Relation to Post-Term Birth Rate

    DEFF Research Database (Denmark)

    Thagaard, Ida Näslund; Krebs, Lone; Lausten-Thomsen, Ulrik

    2016-01-01

    with spontaneous delivery was performed from 2006 to 2012 at Copenhagen University Hospital, Holbæk, Denmark. We determined the duration of pregnancy calculated by last menstrual period, crown rump length (CRL), biparietal diameter (1st trimester), BPD (2nd trimester), and head circumference and compared mean.......3% when BPD (2nd trimester) is used. Calibration for these discrepancies resulted in a lower post-term birth rate, from 3.1-1.4%, when first compared to second trimester dating was used. CONCLUSIONS: Systematic discrepancies were identified when biometric formulas were used to determine duration...

  17. Use of complementary and alternative medicines during the third trimester.

    Science.gov (United States)

    Pallivalapila, Abdul Rouf; Stewart, Derek; Shetty, Ashalatha; Pande, Binita; Singh, Rajvir; McLay, James S

    2015-01-01

    To estimate the prevalence, indications, and associated factors for complementary and alternative medicine use during the last trimester of pregnancy. A questionnaire survey was conducted of women with a live birth (N=700) admitted to the postnatal unit at the Royal Aberdeen Maternity Hospital, northeast Scotland. Outcome measures included: complementary and alternative medicine used; vitamins and minerals used; reasons for complementary and alternative medicine use; independent associated factors for use; views; and experiences. Descriptive and inferential statistical analysis was performed. The response rate was 79.6% of eligible women. Two thirds of respondents (61.4%) reported using complementary and alternative medicine, excluding vitamins and minerals, during the third trimester. Respondents reported using a total of 30 different complementary and alternative medicine modalities, of which oral herbal products were the most common (38% of respondents, 40 different products). The independent associated factors for complementary and alternative medicine use identified were: complementary and alternative medicine use before pregnancy (odds ratio [OR] 4.36, 95% confidence interval [CI] 2.39-7.95, Pcomplementary and alternative medicine use by family or friends (OR 2.36, 95% CI 1.61-3.47, Pcomplementary and alternative medicines were safer than prescribed medicines (P=.006), less likely to be associated with side effects (P≤.001), and could interfere with conventional medicines (P≤.001). Despite the majority of respondents, and notably users, being uncertain about their safety and effectiveness, complementary and alternative medicine modalities and complementary and alternative medicine products are widely used during the third trimester of pregnancy in this study population. Although prior use was the most significant independent associated factor, the role of family and friends, rather than health professionals, in the decision to use complementary and

  18. Early Biochemical Screening for Fetal Aneuploidy in the First Trimester

    DEFF Research Database (Denmark)

    Tørring, Niels

    2013-01-01

    8+0 to 14+0 weeks, and clinical test performance of risk assesment was conducted. Results The in-between day imprecision of the Elecsys® free βhCG and PAPP-A assays were between 1.0 and 2.8%. Comparison (Passing/Bablok regression) of free βhCG and PAPP-A from Roche Elecsys® and the Brahms Kryptor...... with the standards for biochemical assays for prenatal screening set by the Fetal Medicine Foundation, with low assay imprecision, and a high clinical performance of prenatal screening for fetal trisomy in the first trimester....

  19. [Diagnosis of cardiac rhabdomyoma in the first trimester of pregnancy].

    Science.gov (United States)

    Cotaina, G L; Lázaro, G E; Jiménez, M I; Savirón, C R; Lerma, P D

    2016-03-01

    Rhabdomyoma is the most common cardiac tumor detected during fetal life and childhood; despite of this, its incidence is very low. cardiac rhabdomyoma diagnosed at first trimester ultrasound. Early diagnosis is important for performing further studies to detect the possible presence of associated anomalies, including TS (tuberous sclerosis). Prognosis is conditioned by number, size and location. In our case, the presence of early hypoplastic right ventricle and pulmonar and tricuspid atresia (probably because of tumor size) conditioned a very bad prognosis, so the patient decided termination of pregnancy.

  20. Sexual function of pregnant women in the third trimester

    Directory of Open Access Journals (Sweden)

    Nülüfer Erbil

    2018-06-01

    Full Text Available Introduction: Physical, hormonal and psychological changes during pregnancy can affect a woman’s sexuality as well as a couple’s sexual relationship. The aim of this study was to examine sexual function of pregnant women in the third trimester of pregnancy. Methods: The data of descriptive and cross-sectional study was collected via a questionnaire form and Female Sexual Function Index. A score ≤ 26.55 is classified as female sexual dysfunction. A total of 125 volunteer healthy and married pregnant women in third trimester of pregnancy who admitted to the antenatal policlinics were included in this study. Results: The determined that 92% of participants had sexual dysfunction. The Female Sexual Function Index and domains scores in the 28th-31st, 32nd-35th and 36th and higher gestational weeks of pregnancy were as follows: sexual desire scores, 2.50, 2.77 and 2.40; sexual arousal scores, 2.26, 2.72 and 1.69; lubrication scores, 2.61, 3.42 and 1.97; orgasm scores, 2.51, 2.85 and 1.78; sexual satisfaction scores, 3.17, 3.77 and 2.66; pain scores, 2.44, 2.72 and 1.66, and total Female Sexual Function Index scores were 15.51, 18.29, 12.26, respectively. Sexual arousal (p = 0.008, lubrication (p = 0.001, orgasm (p = 0.031, sexual satisfaction (p = 0.005, pain (p = 0.049 and total Female Sexual Function Index score (p = 0.004 were the lowest in 36th and higher gestational weeks, and only sexual desire did not differ (p = 0.191. Conclusions: Sexual function of pregnant women in the third trimester were negatively effected. Health professionals should be trained to evaluate sexual difficulties in pregnant women and to recommend possible solutions. Keywords: Pregnancy, Sexuality, Third trimester, Female sexual function index

  1. First-trimester Down syndrome screening: pregnant women's knowledge

    DEFF Research Database (Denmark)

    Dahl, K; Hvidman, L; Jørgensen, FS

    2011-01-01

    OBJECTIVES: The primary aim of this study was to assess pregnant women's knowledge of first trimester combined Down's syndrome screening in a setting of required informed consent. Secondary, we wanted to identify relevant differences in knowledge level among subgroups of pregnant women, including...... of adverse findings other than Down's syndrome. Knowledge level was positively associated with length of education (adjusted ORs 1.0 (0.8-1.4) to 3.9 (2.4-6.4)) and participation in the screening programme (adjusted OR 0.9 (0.6-1.3) to 5.9 (3.9-8.8)). Participation in an individual information session...

  2. First trimester Down's syndrome screening - pregnant women's knowledge

    DEFF Research Database (Denmark)

    Dahl, Katja; Hvidman, Lone; Jørgensen, Finn Stener

    2011-01-01

    OBJECTIVES: The primary aim of this study was to assess pregnant women's knowledge of first trimester combined Down's syndrome screening in a setting of required informed consent. Secondary, we wanted to identify relevant differences in knowledge level among subgroups of pregnant women, including...... of adverse findings other than Down's syndrome. Knowledge level was positively associated with length of education (adjusted ORs 1.0 (0.8-1.4) to 3.9 (2.4-6.4)) and participation in the screening programme (adjusted OR 0.9 (0.6-1.3) to 5.9 (3.9-8.8)). Participation in an individual information session...

  3. Clinical guidelines. Labor induction abortion in the second trimester.

    Science.gov (United States)

    Borgatta, Lynn; Kapp, Nathalie

    2011-07-01

    Labor induction abortion is effective throughout the second trimester. Patterns of use and gestational age limits vary by locality. Earlier gestations (typically 12 to 20 weeks) have shorter abortion times than later gestational ages, but differences in complication rates within the second trimester according to gestational age have not been demonstrated. The combination of mifepristone and misoprostol is the most effective and fastest regimen. Typically, mifepristone 200 mg is followed by use of misoprostol 24-48 h later. Ninety-five percent of abortions are complete within 24 h of misoprostol administration. Compared with misoprostol alone, the combined regimen results in a clinically significant reduction of 40% to 50% in time to abortion and can be used at all gestational ages. However, mifepristone is not widely available. Accordingly, prostaglandin analogues without mifepristone (most commonly misoprostol or gemeprost) or high-dose oxytocin are used. Misoprostol is more widely used because it is inexpensive and stable at room temperature. Misoprostol alone is best used vaginally or sublingually, and doses of 400 mcg are generally superior to 200 mcg or less. Dosing every 3 h is superior to less frequent dosing, although intervals of up to 12 h are effective when using higher doses (600 or 800 mcg) of misoprostol. Abortion rates at 24 h are approximately 80%-85%. Although gemeprost has similar outcomes as compared to misoprostol, it has higher cost, requires refrigeration, and can only be used vaginally. High-dose oxytocin can be used in circumstances when prostaglandins are not available or are contraindicated. Osmotic dilators do not shorten induction times when inserted at the same time as misoprostol; however, their use prior to induction using misoprostol has not been studied. Preprocedure-induced fetal demise has not been studied systematically for possible effects on time to abortion. While isolated case reports and retrospective reviews document

  4. First Trimester Maternal Glycated Hemoglobin and Sex Hormone-Binding Globulin Do Not Predict Third Trimester Glucose Intolerance of Pregnancy.

    Science.gov (United States)

    Berggren, Erica K; Boggess, Kim A; Mathew, Leny; Culhane, Jennifer

    2017-04-01

    Early pregnancy prediction of third trimester glucose intolerance may identify a population of women whose trajectory toward gestational diabetes mellitus (GDM) is modifiable. We assessed whether first trimester glycated hemoglobin (HbA1c) and sex hormone-binding globulin (SHBG), markers of insulin resistance, predicted third trimester glucose intolerance. Nondiabetic women with singleton pregnancies enrolled in a prospective observational study, 11 0/7 to 14 6/7 weeks. At enrollment, maternal characteristics, medical history, and blood samples were collected for HbA1c and SHBG. Two-step GDM screening was performed, 22 0/7 to 33 6/7 weeks. A 50 g oral glucose tolerance test ≥130 mg/dL defined screen positive, or glucose intolerance. Carpenter-Coustan criteria diagnosed GDM. Means HbA1c and SHBG were compared between glucose-intolerant versus normoglycemic women, and GDM versus no GDM women. We report unadjusted and adjusted odds ratios (OR; 95% confidence interval [CI]) of regression analyses. Adjusted models include race, enrollment body mass index, and history of GDM. Among 250 women, 29% were glucose intolerant and 6% had GDM. Among glucose-intolerant women, HbA1c was higher (5.3 ± 0.3 vs. 5.1 ± 0.3, P = .01) and associated with glucose intolerance in unadjusted, but not adjusted, models (OR: 2.9, 95% CI: 1.2-7.1; adjusted odds ratio [aOR]: 2.0, 95% CI: 0.7-5.4). Among GDM women, HbA1c was higher (5.4 ± 0.4 vs 5.2 ± 0.3, P = .002) and SHBG was lower (228 ± 72 vs 288 ± 93 mmol/L, P = .02). The HbA1c predicted GDM in unadjusted (OR: 13.2, 95% CI: 2.6-68.0) but not adjusted (aOR: 6.7, 95% CI: 0.8-55.2) models. Although metabolic alterations may well precede third trimester glucose intolerance, neither HbA1c of SHBG remained an independent predictor of glucose intolerance or GDM in adjusted models.

  5. Relationships among Constitution, Stress, and Discomfort in the First Trimester

    Directory of Open Access Journals (Sweden)

    Hsiao-Ling Wang

    2012-01-01

    trimester of pregnancy. We adopted a descriptive and correlational research design and collected data from 261 pregnant women during their first trimester in southern Taiwan using structured questionnaires. Results showed that (1 stress was significantly and positively correlated with Yang-Xu, Yin-Xu, and Tan-Shi-Yu-Zhi constitutions, respectively; (2 Yin-Xu and Tan-Shi-Yu-Zhi constitutions had significant correlations with all symptoms of discomfort, while Yang-Xu had significant correlations with all symptoms of discomfort except for “running nose”; (3 Tan-Shi-Yu-Zhi constitution and stress were two indicators for “fatigue”; Tan-Shi-Yu-Zhi was the indicator for “nausea”; Yang-Xu and Yin-Xu were indicators for “frequent urination.” Our findings also indicate that stress level affects constitutional changes and that stress and constitutional change affect the incidence of discomfort. This research can help healthcare professionals observe these discomforts and provide individualized care for pregnant women, to nurture pregnant women into neutral-type constitution, minimize their levels of discomfort, and promote the health of the fetus and the mother.

  6. First trimester caesarean scar ectopic pregnancy evaluation using MRI

    International Nuclear Information System (INIS)

    Peng, K.-W.; Lei, Z.; Xiao, T.-H.; Jia, F.-G.; Zhong, W.-X.; Gao, Y.; Shen, B.-X.; Xie, J.-W.

    2014-01-01

    Aim: To determine the features of caesarean scar ectopic pregnancy (CSP) by using magnetic resonance imaging (MRI) in the first trimester. Materials and methods: Thirty-nine women with CSP in the first trimester were initially selected and underwent transvaginal ultrasound and MRI examinations. Thirty-five patients with CSP were finally included in this study. Results: The CSPs were categorized into three groups: type I, in which a thin-walled diverticulum is present at the caesarean section scar (CSS) defect and the gestational sac (GS) is embedded in the diverticulum; type II, in which a thin-walled diverticulum is present at the CSS defect and the GS is partially embedded in the diverticulum; type III, in which a niche is present in the CSS defect and the GS is mainly embedded in the isthmus. Types I, II, and III CSP occurred in 40, 46, and 14% of the women, respectively. There was no significant difference between the three types in the minimum thickness of the CSS defect. In types I and II, there was a positive correlation in the maximum inlet diameter of the CSS defect and the approximate area of the GS. Conclusion: Using MRI, most CSPs present as a diverticulum at the CSS defect, and the CSS defect becomes weaker with the growth of the GS. MRI showed detailed features of the CSP

  7. Evaluation of Serum Anion gap in the three trimesters of pregnancy ...

    African Journals Online (AJOL)

    This study is aimed at determining anion gap in the three trimesters of pregnancy. The study involved a total of 80 volunteers from the St. Philomena Catholic hospital, Benin City. The volunteers comprised 20 nonpregnant control, and 20 pregnant women in each of the three trimesters of pregnancy. Ethical approval was ...

  8. Maternal anemia in various trimesters and its effect on newborn weight and maturity: An observational study

    Directory of Open Access Journals (Sweden)

    K Jagadish Kumar

    2013-01-01

    Conclusions: The incidence of low birth weight babies was significantly more in mothers who were anemic in their third trimester. Preterm deliveries occurred more frequently in mothers who were anemic in their second and third trimesters. Higher hemoglobin did not show any effect on either birth weight or gestation in our study.

  9. [Termination of pregnancy in the 2nd trimester: mifepriston/misoprostol preferable to sulprostone

    NARCIS (Netherlands)

    Ebbers, S.; Creemers, J.W.T.; Lotgering, F.K.

    2009-01-01

    OBJECTIVE: To compare the efficacy of sulprostone and mifepristone/misoprostol when used for termination of pregnancy (TOP) in the 2nd trimester. DESIGN: Comparative retrospective cohort study. METHOD: Data were collected on all women whose pregnancies were terminated in the 2nd trimester, in the

  10. The value of routine mid-trimester ultrasound in low-risk ...

    African Journals Online (AJOL)

    This study investigated the effect of routine second-trimester ultrasound scanning on obstetric management and pregnancy outcomes. This was an open cluster, randomised, controlled trial. Clusters of women with low-risk pregnancies presenting in the second trimester were randomised to receive an ultrasound scan ...

  11. ADAM 12 as a second-trimester maternal serum marker in screening for Down syndrome

    DEFF Research Database (Denmark)

    Christiansen, Michael; Spencer, Kevin; Laigaard, Jennie

    2007-01-01

    ADAM 12 is a placenta-derived glycoprotein that is involved in growth and differentiation. The maternal serum concentration of ADAM 12 is a potential first-trimester maternal serum marker of Down syndrome (DS). Here we examine the potential of ADAM 12 as a second-trimester maternal serum marker...

  12. Fetal first trimester growth is not associated with kidney outcomes in childhood

    NARCIS (Netherlands)

    H. Bakker (Hanneke); R. Gaillard (Romy); A. Hofman (Albert); I.K.M. Reiss (Irwin); E.A.P. Steegers (Eric); V.W.V. Jaddoe (Vincent)

    2017-01-01

    textabstractBackground: Impaired fetal growth is associated with increased risks of kidney diseases in later life. Because human development rates are highest during the first trimester, this trimester may be a particularly critical period for kidney outcomes. We have therefore examined the

  13. A rare case of hypercalcemia-induced pancreatitis in a first trimester pregnant woman

    Directory of Open Access Journals (Sweden)

    Carine Ghassan Richa

    2018-04-01

    Full Text Available The objective of the study is to report a case of acute pancreatitis secondary to hypercalcemia induced by primary hyperparathyroidism in a pregnant woman at the end of the first trimester. The case included a 32-year-old woman who was diagnosed with acute pancreatitis and severe hypercalcemia refractory to many regimens of medical therapy in the first trimester of pregnancy. She was successfully treated with parathyroidectomy in the early second trimester with complete resolution of hypercalcemia and pancreatitis. Neonatal course was unremarkable. To our best knowledge, this is a rare case when primary hyperparathyroidism and its complications are diagnosed in the first trimester of pregnancy. In conclusion, primary hyperparathyroidism is a rare life-threatening condition to the fetus and mother especially when associated with complications such as pancreatitis. Early therapeutic intervention is important to reduce the morbidity and mortality. Parathyroidectomy performed in the second trimester can be the only solution.

  14. Induced second trimester abortion and associated factors in Amhara region referral hospitals.

    Science.gov (United States)

    Mulat, Amlaku; Bayu, Hinsermu; Mellie, Habtamu; Alemu, Amare

    2015-01-01

    Although the vast majority of abortions are performed in the first trimester, still 10-15% of terminations of pregnancies have taken place in the second trimester period globally. As compared to first trimester, second trimester abortions are disproportionately contribute for maternal morbidity and mortality especially in low-resource countries where access to safe second trimester abortion is limited. The main aim of this study was to assess the prevalence and associated factors of induced second trimester abortion in Amhara region referral hospitals, northwest Ethiopia. Institution based cross-sectional study was conducted in Amhara region referral hospitals among 416 women who sought abortion services. Participants were selected using systematic sampling technique. Data were collected using pretested structured questionnaire through interviewing. After the data were entered and analyzed; variables which have P value effect with 95% CI and P value abortion was 19.2%. Being rural (AOR = 1.86 [95% CI = 1.11-3.14]), having irregular menstrual cycle (AOR = 1.76 [95% CI = 1.03-2.98]), not recognizing their pregnancy at early time (AOR = 2.05 [95% CI = 1.21-3.48]), and having logistics related problems (AOR = 2.37 [95% CI = 1.02-5.53]) were found to have statistically significant association with induced second trimester abortion. Induced second trimester abortion is high despite the availability of first trimester abortion services. Therefore, increase accessibility and availability of safe second trimester abortion services below referral level, counseling and logistical support are helpful to minimize late abortions.

  15. Effect of sintering temperature on optical properties and microstructure of translucent zirconia prepared by high-pressure spark plasma sintering

    Directory of Open Access Journals (Sweden)

    Haibin Zhang, Byung-Nam Kim, Koji Morita, Hidehiro Yoshida Keijiro Hiraga and Yoshio Sakka

    2011-01-01

    Full Text Available Aiming to characterize the effect of sintering temperature on transparency of zirconia, we have evaluated the optical properties and microstructure of translucent cubic zirconia prepared by high-pressure spark plasma sintering (SPS at 1000–1200 circleC. Color centers (oxygen vacancies with trapped electrons and residual pores were primary defects in the samples. In SPS samples, the total forward transmittance and in-line transmittance are mainly affected by color centers with a limited contribution from residual pores; in contrast, the changes in reflectance are only related to the porosity. The amounts of color centers and residual pores increase with sintering temperature that reduces the total forward and in-line transmittance of the as-sintered zirconia. Annealing in oxidizing atmosphere improves the total forward and in-line transmittance. During the annealing, the concentration of color centers decreases but the porosity increases.

  16. Genome-scale transcriptome analysis of the alpine "glasshouse" plant Rheum nobile (Polygonaceae with special translucent bracts.

    Directory of Open Access Journals (Sweden)

    Lizhong Wang

    Full Text Available Rheum nobile is an alpine plant with translucent bracts concealing the inflorescence which produce a "glasshouse" effect promoting the development of fertile pollen grains in such conditions. The current understanding of the adaptation of such bracts to alpine environments mainly focuses on the phenotypic and physiological changes while the genetic basis is very limited. By sequencing the upper bract and the lower rosulate leaf from the same R. nobile stem, we identified candidate genes that may be involved in alpine adaption of the translucent bract in "glasshouse" plants and illustrated the changes in gene expression underlying the adaptive and complex evolution of the bracts phenotype.A total of 174.2 million paired-end reads from each transcriptome were assembled into 25,249 unigenes. By comparing the gene expression profiles, we identified 1,063 and 786 genes up-regulated respectively in the upper bract and the lower leaf. Functional enrichment analyses of these genes recovered a number of differential important pathways, including flavonoid biosynthesis, mismatch repair and photosynthesis related pathways. These pathways are mainly involved in three types of functions: 9 genes in the UV protective process, 9 mismatch repair related genes and 88 genes associated with photosynthesis.This study provides the first comprehensive dataset characterizing Rheum nobile gene expression at the transcriptomic scale, and provides novel insights into the gene expression profiles associated with the adaptation of the "glasshouse" plant bracts. The dataset will be served as a public genetic resources for further functional and evolutionary studies of "glasshouse" plants.

  17. The effect of variations in translucency and background on color differences in CAD/CAM lithium disilicate glass ceramics.

    Science.gov (United States)

    Al Ben Ali, Abdulaziz; Kang, Kiho; Finkelman, Matthew D; Zandparsa, Roya; Hirayama, Hiroshi

    2014-04-01

    The purpose of this study was to compare the effect of variations in translucency and background on color differences (ΔE) for different shades of computer-aided design and computer-aided manufacturing (CAD/CAM) lithium disilicate glass ceramics. A pilot study suggested n = 10 as an appropriate sample size for the number of lithium disilicate glass ceramic cylinders per group. High-transparency (HT) and low-transparency (LT) cylinders (diameter, 12 mm; length, 13 mm) were fabricated in three ceramic shades (BL1, A2, C3) using CAD/CAM technology and were cut into specimen disks (thickness, 1.2 mm; diameter, 12 mm) for placement on Natural Die (ND1 and ND4) backgrounds. Four combinations of translucency and background color were evaluated in terms of color differences for the three ceramic shades: group 1 (HT ND1, reference), group 2 (HT ND4), group 3 (LT ND1), and group 4 (LT ND4). A spectrophotometer was used to measure the color differences. Nonparametric tests (Kruskal-Wallis tests) were used to evaluate the color differences among the tested groups, and Mann-Whitney U tests with Bonferroni correction were used as post hoc tests. Furthermore, for each ceramic shade, the HT groups were compared to the LT groups using the Mann-Whitney U test. Significant differences were present among the tested groups of the same ceramic shade (p glass ceramic color among the BL1, A2, and C3 ceramic shades. Changing the underlying color from a lighter background to a darker background resulted in increased color differences. © 2013 by the American College of Prosthodontists.

  18. First trimester nicotine exposure and the risk of infantile colic

    DEFF Research Database (Denmark)

    Milidou, Ioanna; Henriksen, Tine Brink; Jensen, Morten Søndergaard

    Background: Although prenatal exposure to maternal smoking has been associated with infantile colic (IC), to date no published studies have reported on the relationship between the prenatal use of nicotine replacement therapy (NRT) and IC. Aim: We aimed to assess the relationship between fetal...... exposure to nicotine, coming from both cigarette smoking and use of NRT early in pregnancy, and IC. Methods: The study population consisted of 63,883 pregnancies that resulted in live born singletons enrolled in the Danish National Birth Cohort between 1997 and 2002. Mother’s smoking habits and use of NRT......: The results indicate that prenatal exposure to nicotine from any source during the first trimester of the pregnancy increases the risk of infantile colic....

  19. First trimester Down's syndrome screening - pregnant women's knowledge

    DEFF Research Database (Denmark)

    Dahl, Katja; Hvidman, Lone; Jørgensen, Finn Stener

    2011-01-01

    OBJECTIVES: The primary aim of this study was to assess pregnant women's knowledge of first trimester combined Down's syndrome screening in a setting of required informed consent. Secondary, we wanted to identify relevant differences in knowledge level among subgroups of pregnant women, including...... obstetric departments offering prenatal screening free of charge. Both participants and non-participants in the screening programme were included. The results are based on 4,095 responders (64%). Differences between sub-groups were examined by chi-squared tests and logistic regression analysis. Estimates...... are stated with 95% CI. RESULTS: The majority of the participants (87.6% (86.6-88.6) to 92.6% (91.7-93.3)) correctly identified the test concept and the main condition being screened for. Fewer participants (16.4% (15.3-17.6) to 43.3% (41.8-44.8)) correctly recognised test accuracy and the potential risk...

  20. A Fetus with Iniencephaly Delivered at the Third Trimester

    Directory of Open Access Journals (Sweden)

    Esra Cinar Tanriverdi

    2015-01-01

    Full Text Available Iniencephaly is an uncommon neural tube defect, having retroflexion of the head without a neck and severe distortion of the spine. Iniencephaly is classified into two groups, iniencephaly apertus (with encephalocele and iniencephaly clausus (without encephalocele. Incidence ranges from 0.1 to 10 in 10.000 pregnancies and it is seen more frequently in girls. Most of the fetuses with this defect die before birth or soon after birth, while those with the milder forms may live through childhood. Recurrence risk is around 1–5%. Family should be offered termination to reduce maternal risks and counseled for folic acid supplementation before the next planned pregnancy. Here we present a rare case of iniencephaly clausus which was diagnosed at 18th week of gestation by ultrasonography and delivered in the third trimester of pregnancy due to rejection of termination.

  1. Transabdominal chorion villus biopsi ved abnormt ultralydfund i 2. trimester

    DEFF Research Database (Denmark)

    Hertz, Jens Michael; Jensen, P K; Henriques, U

    1990-01-01

    If oligohydramnios, growth retardation or foetal malformations are demonstrated by ultrasonic scanning in the second or third trimesters, this implies that the risk of chromosome anomalies is significantly increased. In cases such as these, determination of the foetal karyotype may therefore...... be indicated. Until recently, amniocentesis has been employed for this but the results of the chromosome investigation are not available until two to three weeks after the intervention. The delay between amniocentesis and the result of chromosome investigation imposes a mental strain on the pregnant woman...... oligohydramnios, growth retardation or foetal malformations have been demonstrated by ultrasonic scanning, in cases where referral for antenatal diagnosis is very late and when chromosome investigation after amniocentesis proves unsuccessful and repeated amniocentesis would result in an unacceptably late result....

  2. First-trimester prenatal diagnosis of Tay-Sachs disease.

    Science.gov (United States)

    Grabowski, G A; Kruse, J R; Goldberg, J D; Chockkalingam, K; Gordon, R E; Blakemore, K J; Mahoney, M J; Desnick, R J

    1984-01-01

    The prenatal diagnosis of Tay-Sachs disease was made in two at-risk fetuses by the analysis of chorionic villi obtained at 9 and 11 menstrual weeks, respectively. The diagnoses were based on the absence of beta-hexosaminidase A activity as determined by: (1) specific enzyme assays, (2) anion-exchange chromatography, and (3) cellulose acetate gel electrophoresis. The enzymatic diagnoses were confirmed on fetal tissue as well as by ultrastructural demonstration of the first-trimester fetal neuropathology. Optimal assay conditions for beta-hexosaminidase A in chorionic villi were established for the prenatal diagnosis of Tay-Sachs disease. Importantly, it was noted that a small amount of decidua or maternal blood could lead to misdiagnosis. Thus, extreme care must be taken in the preparation of chorionic villi for Tay-Sachs as well as other prenatal metabolic diagnoses. Images Fig. 1 Fig. 3 Fig. 4 PMID:6240199

  3. Magnetic resonance imaging of three-dimensional cervical anatomy in the second and third trimester.

    Science.gov (United States)

    House, Michael; Bhadelia, Rafeeque A; Myers, Kristin; Socrate, Simona

    2009-05-01

    Although a short cervix is known to be associated with preterm birth, the patterns of three-dimensional, anatomic changes leading to a short cervix are unknown. Our objective was to (1) construct three-dimensional anatomic models during normal pregnancy and (2) use the models to compare cervical anatomy in the second and third trimester. A cross-sectional study was performed in a population of patients referred to magnetic resonance imaging (MRI) for a fetal indication. Using magnetic resonance images for guidance, three-dimensional solid models of the following anatomic structures were constructed: amniotic cavity, uterine wall, cervical stroma, cervical mucosa and anterior vaginal wall. To compare cervical anatomy in the second and third trimester, models were matched according the size of the bony pelvis. Fourteen patients were imaged and divided into two groups according to gestational age: 20-24 weeks (n=7)) and 31-36 weeks (n=7). Compared to the second trimester, the third trimester was associated with significant descent of the amniotic sac (p=.02). Descent of the amniotic sac was associated with modified anatomy of the uterocervical junction. These three-dimensional changes were associated with a cervix that appeared shorter in the third trimester. We report a technique for constructing MRI-based, three-dimensional anatomic models during pregnancy. Compared to the second trimester, the third trimester is associated with three-dimensional changes in the cervix and lower uterine segment.

  4. Fetal first trimester growth is not associated with kidney outcomes in childhood.

    Science.gov (United States)

    Bakker, Hanneke; Gaillard, Romy; Hofman, Albert; Reiss, Irwin K; Steegers, Eric A P; Jaddoe, Vincent W V

    2017-04-01

    Impaired fetal growth is associated with increased risks of kidney diseases in later life. Because human development rates are highest during the first trimester, this trimester may be a particularly critical period for kidney outcomes. We have therefore examined the association of fetal first trimester growth with kidney outcomes in childhood. This study was embedded in a prospective population-based cohort study among 1176 pregnant women and their children. We used fetal first trimester crown-length as the growth measure among mothers with a regular menstrual cycle and a known first day of the last menstrual period. At the childhood age of 6 (median 5.7-6.8) years, we measured combined kidney volume, microalbuminuria and estimated glomerular filtration rate (eGFR) based on serum creatinine and cystatin C concentrations. No consistent associations of fetal first trimester crown-rump length with childhood combined kidney volume, eGFR and microalbuminuria were observed. Compared to children with a fetal first trimester crown-rump length in the highest quintile, those in the lowest quintile had a larger childhood combined kidney volume (difference 5.32 cm 3 , 95 % confidence interval 1.06 to 9.57), but no differences in kidney function. Our results do not support the hypothesis that fetal first trimester growth restriction affects kidney size and function in childhood. Further studies are needed to focus on critical periods in early life for kidney function and disease in later life.

  5. Trimester- and Assay-Specific Thyroid Reference Intervals for Pregnant Women in China

    Directory of Open Access Journals (Sweden)

    Jinfang Xing

    2016-01-01

    Full Text Available Objective. The guidelines of the American Thyroid Association (ATA recommend an upper limit reference interval (RI of thyroid stimulating hormone (TSH of 2.5 mIU/L in the first trimester of pregnancy and 3.0 mIU/L in subsequent trimesters, but some reported ranges in China are significantly higher. Our study aimed to establish trimester- and assay-specific RIs for thyroid hormones in normal pregnant Chinese women. Methods. In this cross-sectional study, 2540 women with normal pregnancies (first trimester, n=398; second trimester, n=797; third trimester, n=1345 and 237 healthy nonpregnant control subjects were recruited. Serum TSH, free thyroxin (FT4, thyroid peroxidase antibody (TPOAb, and thyroglobulin antibody (TgAb levels were determined by automated chemiluminescence with an Immulite 2000 system (Siemens, Erlangen, Germany. After outliers were excluded, the 2.5–97.5th percentiles were used to define the RIs. Results. The RIs of thyroid function in the first, second, and third trimesters of pregnancy and in nonpregnant controls were 0.07–3.96, 0.27–4.53, 0.48–5.40, and 0.69–5.78 mIU/L for TSH and 9.16–18.12, 8.67–16.21, 7.80–13.90, and 8.24–16.61 pmol/L for FT4, respectively. Conclusion. The trimester- and assay-specific RIs of thyroid function during pregnancy differed between trimesters, which suggests that it is advisable to detect and avoid misclassification of thyroid dysfunction during pregnancy for women in Henan, China.

  6. Relationships between Cell-Free DNA and Serum Analytes in First and Second Trimesters of Pregnancy

    Science.gov (United States)

    Vora, Neeta L.; Johnson, Kirby L.; Lambert-Messerlian, Geralyn; Tighiouart, Hocine; Peter, Inga; Urato, Adam C.; Bianchi, Diana W.

    2010-01-01

    Objective Circulating cell-free DNA and maternal serum analytes are indicators of fetal and placental condition. Little is known about the relationship of these noninvasive markers to each other, particularly in the first trimester. Our goal was to assess the relationship between first and second trimester cell-free DNA levels and maternal serum screening markers. Methods First and second trimester residual maternal serum samples from 50 women were obtained. First trimester (pregnancy-associated plasma protein A [PAPP-A] and β-hCG), and second trimester serum analytes (β-hCG, alpha-fetoprotein [AFP], unconjugated estriol and inhibin A) had been measured at the time of sample receipt. All fetuses were male, as confirmed by birth records. Cell-free DNA was extracted and measured by real-time quantitative polymerase chain reaction (PCR) amplification using glyceraldehyde phosphate dehydrogenase (GAPDH) and DYS1 as markers of total DNA and fetal DNA, respectively. Determination of linear associations between first and second trimester serum markers and cell-free DNA levels using Pearson correlations was performed. Results Statistically significant correlations between first trimester PAPP-A multiples of the median (MoMs) and both total (r=0.36, p=0.016) and fetal (r= 0.41, p=0.006) DNA in the first trimester were observed. There were no significant correlations between first trimester serum hCG or any second trimester serum marker with DNA levels. Conclusions Correlation between serum PAPP-A and first trimester circulating cell-free fetal and total DNA levels is a novel finding. PAPP-A is a glycoprotein of placental origin, and its correlation to cell-free fetal DNA in maternal serum suggests a common tissue origin, through apoptosis of placental cells. However, since PAPP-A and cell-free DNA were only marginally correlated and cell-free DNA can be reliably detected in the first trimester, the addition of cell-free DNA to serum screening strategies may be helpful in

  7. THIRD TRIMESTER OF PREGNANCY: CARPAL TUNNEL SYNDROME, ANXIETY AND DEPRESSION

    Directory of Open Access Journals (Sweden)

    Tupković Emir

    2013-01-01

    Full Text Available This study measured the frequency of carpal tunnel syndrome (CTS and the levels of anxietyand depression in the third trimester of healthy pregnant women having regular prenatal visits. The study was performed at the Department of Neurophysiology Health Centre Tuzla in the period of January through April 2006. The group consisted of 40 pregnant women in the third trimester of pregnancy, age range of 25.6 ± 4.9 years. The control group consisted of healthy women, ages 31.1 ± 4.4 years. The electrophysiological parameters n. medians, the Beck Depression Inventory (BDI and Beck Anxiety Inventory (BAI were measured. The diagnosis of CTS is neurophysiologically confirmed in 12 pregnant women (30% and 75% showed clinical signs and symptoms of disease. Pain was measured by subjective pain scale ranked from 0 (absence of pain to 10 (severe pain. The mean value of BAI in control group was 8.6 ± 6.5, while in the group of pregnant women was 12.9 ± 6.9, which was significantly higher (p =0.011. The mean value of BDI in control group was 4.2 ± 4.4 and in the group of pregnant women was 8.7 ± 5.9. which was significantly higher (p = 0.0008, The mean value of BAI in the group of women with CTS was 12.25 ± 6.7 which was not significantly higher than the compared to the control group (p = 0.113. The mean value of BDI in the group of pregnant women with CTS was 7.9 ± 6.4,which was significantly higherwhen compared to the control group (p = 0.037. The subjective assessment of pain in the group of womenwith CTSwas 2.4 ± 2.1. There was a slight correlation between pain intensity and degree of BAI (r = 0.289 and a negative correlation with the level of depression (r = – 0.297. The conclusion is that pregnant women with normal risk shouldmake an extra effort in the treatment of unpleasant conditions such as CTS, anxiety and depression, which may impair the quality of life and have physical and psychological side effects on the future mother.

  8. Therapeutic termination of second trimester pregnancies with low dose misoprostol

    International Nuclear Information System (INIS)

    Liaquat, N.F.; Javed, I.; Shuja, S.; Shoaib, T.; Bano, K.; Waheed, S.; Ansar, A.

    2006-01-01

    To determine the effectiveness of 50 micro g misoprostol for midtrimester termination of pregnancies. The study subjects were 54 pregnant women admitted during the 2nd trimester (14-26 weeks) of gestation, willing or requiring termination of pregnancy. Those patients were included in the study who were admitted with closed cervical os, either had intrauterine death, fetal anomaly, medical disorder (hypertension or diabetes) or history of previous ceasrean section. Cases of placenta previa, acute asthma, glaucoma, cardiac diseases and allergy to prostaglandins were excluded. Each patient received 50 micro g misoprostol intravaginally. Maximum 4 doses were given at 4 hours interval and state of cervical os was assessed by vaginal examination before insertion of next dose or at the onset of uterine contractions. After 4 doses of misoprostol, patients were kept under observation and watched for uterine contractions to start or for expulsion of products. Syntocinon infusion was started to augment labour where products of conception failed to expel out inspite of open os. Outcome measures include success rate of termination within 12, 24, 36 and 48 hours, mean induction - abortion time interval and maternal side effects. Results: The success rate of termination within 12, 24, 36 and 48 hours were 27.7%, 83.3%, 94.4% and 96.3% respectively. Mean induction to abortion time interval, in case of abortion within 48 hours, was found to be 18.9 +- 11.58 (range 4-48 hours). Dead fetuses were aborted earlier than alive fetuses. The mean induction abortion time interval was 17.01+-8.7 hours in dead and 23.4 +- 15.9 hours in alive fetuses (t -value:1.9, p: 0.05). Two patients failed to deliver within 48 hours of induction. Two patients suffered from febrile illness. Vaginal administration of 50 micro g misoprostol every 4 hourly is an effective and safe agent for ripening of cervix and convenient way of inducing abortion during 2nd trimester of pregnancy in a women either with

  9. Subclinical hypothyroidism in the first trimester of pregnancy in North India

    Directory of Open Access Journals (Sweden)

    Jubbin Jagan Jacob

    2013-01-01

    Full Text Available Subclinical hypothyroidism based on population and trimester specific cut-offs is reported to complicate 1-2% of all pregnancies. Using the recent Endocrine Society guidelines of 2.5 mIU/L of Thyroid Stimulating Hormone as the upper level of normal in the first trimester the reported prevalence of subclinical hypothyroidism is much higher. Recent publications have also emphasized that there is considerable racial variation in the prevalence of thyroid disorders in pregnancy. Among published literature North Indian women appear to have the highest rates of subclinical hypothyroidism in the first trimester of pregnancy. More widespread use of universal screening and trimester specific ranges in pregnancy for thyroid hormonal assays will lead to a large number of North Indian women requiring treatment for thyroid disorders in pregnancy.

  10. Assessment of global DNA methylation in the first trimester fetal tissues exposed to maternal cigarette smoking

    DEFF Research Database (Denmark)

    Fa, Svetlana; Larsen, Trine Vilsbøll; Bilde, Katrine

    2016-01-01

    AIMS: Maternal cigarette smoking during pregnancy increases the risk of negative health consequences for the exposed child. Epigenetic mechanisms constitute a likely link between the prenatal exposure to maternal cigarette smoking and the increased risk in later life for diverse pathologies...... to exposures with an epigenetic impact. We have assessed the influence of maternal cigarette smoking during the first trimester for fetal global DNA methylation. METHODS AND RESULTS: We analyzed the human fetal intestines and livers as well as the placentas from the first trimester pregnancies. Global DNA...... changes in exposure responses to the first trimester maternal cigarette smoking. CONCLUSIONS: Acknowledging that only examining subsets of global DNA methylation markers and fetal sample availability represents possible limitations for the analyses, our presented results indicate that the first trimester...

  11. What are the most common first-trimester ultrasound findings in cases of Turner syndrome?

    Science.gov (United States)

    Wiechec, Marcin; Knafel, Anna; Nocun, Agnieszka; Wiercinska, Ewa; Ludwin, Artur; Ludwin, Inga

    2017-07-01

    To identify the most common first-trimester ultrasound findings in Turner syndrome (TS). To evaluate which first-trimester findings can be best used to predict the likelihood of TS. This was a prospective study, based on singleton pregnancies. The referrals included 6210 patients. Scan protocol covered a review of the early fetal anatomy and markers of aneuploidy. Study population comprised 5644 pregnancies: 5613 with a normal karyotype and 31 cases of TS. Statistically significant differences (p  3.5 mm and right dominant heart (RDH) augmented the risk of TS risk by 991 and 314 times, respectively. First-trimester sonography is a feasible method to identify the most characteristic features of TS fenotype. When the first-trimester pattern of TS is considered, a highly thickened NT, FHR above the 95th percentile, abnormal ductus venosus velocimetry, fetal hydrops, and RDH should be specifically searched for.

  12. Trimester-specific coagulation and anticoagulation reference intervals for healthy pregnancy.

    Science.gov (United States)

    Cui, Chanjuan; Yang, Shuo; Zhang, Jie; Wang, Guojing; Huang, Shengkai; Li, Aiwei; Zhang, Yuncong; Qiao, Rui

    2017-08-01

    Due to the normal physiological need of pregnancy and childbirth, the haemostatic system of pregnant women is different from that of healthy non-pregnant women. The aim of this study was to establish trimester-specific reference intervals of coagulation screening tests and thrombophilia markers in pregnancies without complications of females with Han ethnicity from North China. In total 744 Han healthy pregnant women (first trimester 207 cases, second trimester 222 cases and third trimester 315 cases) and 121 healthy non-pregnant women were recruited in North China. Eight tests-activated partial thromboplastin time (APTT), prothrombin time (PT), thrombin time (TT), fibrinogen (Fib), d-Dimer, antithrombin (AT), protein C (PC) and free protein S (fPS)-were processed on ACL TOP automated coagulation analyzer. The non-parametric 2.5th-97.5th percentiles reference intervals were calculated to establish trimester-specific reference intervals. The reference intervals for APTT, PT, TT, Fib, d-Dimer, AT, PC, and fPS at first trimester were 26.4-41.9s, 9.7-12.5s, 11.7-17.0s, 2.38-4.44g/L, 0.01-0.31μg/mL, 72-120%, 29-150%, 21-143%, respectively. At second trimester, the reference intervals were 24.4-35.8s, 8.5-13.2s, 10.0-16.0s, 2.40-5.97g/L, 0.05-0.73μg/mL, 68-125%, 20-138%, 24-155%, respectively. At third trimester, the reference intervals were 25.6-34.9s, 8.6-12.4s, 11.1-15.5s, 2.79-5.91g/L, 0.14-2.82μg/mL, 56-119%, 20-134%, 17-140%, respectively. From the first trimester to the third trimester, APTT, PT and TT presented shortened trends, Fib and d-Dimer presented increasing trends, AT, PC and fPS activity presented decreasing trends, respectively. The trimester-specific reference intervals of coagulation screening tests and thrombophilia markers in pregnancies without complications of females with Han ethnicity from North China are presented in this study, which may provide effective evidence for doctors to accurately diagnose and treat the disease during pregnancy

  13. Management of necrotizing pancreatitis in the third trimester of pregnancy.

    Science.gov (United States)

    Ducarme, Guillaume; Châtel, Paul; Alves, Arnaud; Hammel, Pascal; Luton, Dominique

    2009-04-01

    Acute pancreatitis during pregnancy is a severe disease with a high materno-fetal mortality, which recently decreased because of earlier diagnosis and improvement in maternal and neonatal intensive care. We describe a 19-year-old woman who presented at 37 weeks gestation with acute abdominal pain and attacks of vomiting. Obstetrical and fetal examinations were normal. Biochemical investigations and magnetic resonance imaging showed a gallstone migration with necrotizing pancreatitis (Balthazar 5 points). Our multidisciplinary team decided on nonsurgical conservative treatment including morphine administration and enteral feeding, and vaginal delivery which was possible 30 h after induction of labor. Follow up was uneventful with a resolution of pain and signs of pancreatitis on imaging. Magnetic resonance imaging can be useful and safe to estimate the severity of acute and necrotizing pancreatitis in the third trimester of pregnancy. In case of sterile necrotizing pancreatitis, nonsurgical conservative treatment and a vaginal delivery should be performed when possible in these patients to reduce the risk of maternal infection.

  14. Maternal attitude towards first trimester screening for fetal abnormalities.

    Science.gov (United States)

    Maiz, Nerea; Burgos, Jorge; Barbazán, Maria José; Recio, Virginia; Martínez-Astorquiza, Txanton

    2016-05-01

    To explore the maternal attitude towards the screening for structural abnormalities at the 11-13-week scan, according to the severity of the abnormality. A secondary aim was to analyse which maternal characteristics influence in the maternal response. This is a descriptive study based on the responses to 300 self-administrated questionnaires completed immediately before routine ultrasounds scan. A totally of 296 (98.7%) women participated in the study. If the baby had any abnormality 93.9% would prefer to know at 12 weeks, 96.6% if the abnormality was lethal, 95.3% if the abnormality involves severe handicap, 91.2% if the abnormality can only be suspected, but not confirmed until the pregnancy is more advanced (16 or 20 weeks), 77.0% if the abnormality was minor and 79.4% women would like to know at 12 weeks if the baby appeared normal. Maternal age, gestational age at the time of the questionnaire and maternal attitude towards termination of pregnancy were the only factors affecting maternal responses. Pregnant women prefer to be informed in the first trimester about any abnormality in their fetuses, even in cases of minor or only suspected abnormalities. © 2016 John Wiley & Sons, Ltd. © 2016 John Wiley & Sons, Ltd.

  15. The introduction of first trimester medical abortion in Armenia.

    Science.gov (United States)

    Louie, Karmen S; Chong, Erica; Tsereteli, Tamar; Avagyan, Gayane; Vardanyan, Susanna; Winikoff, Beverly

    2015-02-01

    In Armenia, abortion is the main means of fertility regulation; however, before research activities were initiated only surgical methods were available and the quality of services was low in some areas. Our clinical study from 2008-2011 aimed to show that early medical abortion is an acceptable and feasible option. A total of 700 eligible women with pregnancies up to 63 days LMP presenting for abortion were recruited for the study in five locations. Participants took 200 mg mifepristone and 800 μg buccal misoprostol 24-48 hours later. They returned for a follow-up visit two weeks after mifepristone administration. 95% of the women had successful abortions and 95% were satisfied with the method. In 2012-2013, we conducted a follow-up assessment to examine the ongoing provision and quality of medical abortion services at the former research sites. Medical record reviews, interviews and observations were carried out three times approximately six months apart. The assessment found that all five sites had continued providing medical abortion, with about half of eligible women choosing the medical method. Four of the five sites were achieving high success rates. Staff turnover and the lack of trained providers likely contributed to the higher failure rate at the fifth site. These findings provide evidence that first trimester medical abortion is an acceptable and feasible option for Armenian women and providers, and that high quality services are being delivered. Copyright © 2015 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

  16. Efficacy of misoprostol for the first trimester pregnancy termination

    Directory of Open Access Journals (Sweden)

    Moezzi-Madani M

    2008-06-01

    Full Text Available Background: Medical induction abortion is an acceptable alternative to surgical abortion for pregnancy termination. Misoprostol is an inexpensive PGE1 analogue that can be used easily and safely as a single agent for first- and second-trimester pregnancy termination. The objective of this study was to evaluate the efficacy of two different doses of vaginal misoprostol for pregnancy termination with gestational age up to 16 weeks.Methods: This clinical trial included 100 pregnant women with gestational age up to 16 weeks requesting legal termination of pregnancy. The subjects were randomized in two equal groups, and received either 200 (group 1 or 400 µg (group 2 misoprostol vaginally every 6 hours with a maximum of four doses. Response to treatment was defined as complete or incomplete abortion within 48 hours after initial dose. Curettage was performed for patients with heavy bleeding or incomplete abortion. The abortion outcome and side-effects were assessed.Results: The groups were similar in maternal age, gestational age, parity and obstetrical history and indication for pregnancy termination. The side effects in group 2 were significantly higher than in group 1 (P<0.05. There were no statistically significant differences between the two groups regarding completeness of the abortion and mean time to abortion induction.Conclusions: In the termination of pregnancies up to 16 weeks, the 200 µg per dose regimen of misoprostol was as effective as the 400 µg regimen; however, side-effects were more common with the higher dose.

  17. Intravenous amino acids in third trimester isolated oligohydramnios

    International Nuclear Information System (INIS)

    Qureshi, F.U.

    2011-01-01

    To determine the efficacy of maternal administration of intravenous amino acid solution in improving amniotic fluid volume in cases of isolated oligohydramnios and to observe its impact on mode of delivery and neonatal outcome. Study Design: A prospective case series. Methodology: Forty two women with singleton pregnancy, well established gestational age and clinically and sonographically proven isolated oligohydramnios in the third trimester before 36 weeks were administered amino acid solution intravenously after excluding cases of premature rupture of membranes, congenital anomaly of fetus, maternal pulmonary, cardiovascular and hypertensive disorders, and severe placental insufficiency (raised S/D ratio). Pre-infusion and postinfusion Amniotic fluid Index (AFI) was measured and repeated weekly. Women were followed till delivery. Results: According to repeated measurement analysis of variance, mean pre-infusion AFI was 4.7 cm, mean one week postinfusion AFI was 5.8 cm, mean two week post-infusion AFI was 6.2 cm and mean three week AFI was 6.3 cm (p-value 0.029, significant). Cesarean section became a predominant mode of delivery in this group without a firm evidence of associated fetal compromise. Conclusion: Amino acid infusion is an effective therapy for raising AFI in isolated oligohydramnios in this case series. Liberal use of cesarean section in this selected group should be carefully re-evaluated. (author)

  18. Sonographic maturation of third-trimester cerebellar foliation after birth.

    Science.gov (United States)

    Korsten, Alex; Lequin, Maarten; Govaert, Paul

    2006-05-01

    The development of cerebellar folia of third-trimester preterms has not been described with ultrasound before. We set out to determine normal development of the pons and cerebellar folia for future measurements of hypoplasia and atrophy. Study sonograms were made in preterms admitted to the neonatal intensive care unit with postmenstrual age (PMA) from 25 wk until term. On a weekly basis, transcranial measurements were made in the axial and coronal planes at the asterion with high-frequency transducers (8.5 and 13 MHz). The axial images showed the pons and fourth ventricle. The coronal images showed cerebellar folia and white matter. In the same coronal plane, the depth of cerebellar fissures at the rostral cerebellar convexity could be observed. A total of 172 cranial sonograms were performed on 98 neonates. The development of folia could be measured with ultrasound through the asterion. We showed that pons area, mean of three fissure depths, hemisphere area, and number of folia in the horizontal fissure correlated significantly with PMA. Hemisphere area described the same trend of growth as the transverse cerebellar diameter used in fetal sonography.

  19. Medical treatment of second-trimester fetal miscarriage; A retrospective analysis

    OpenAIRE

    Niinimaki, Maarit; Mentula, Maarit; Jahangiri, Reetta; Mannisto, Jaana; Haverinen, Annina; Heikinheimo, Oskari

    2017-01-01

    Abstract Objectives: Research on the treatment of second-trimester miscarriages is scarce. We studied the outcomes, and the factors associated with adverse events and need for hospital resources in the medical treatment of second-trimester miscarriage. Materials and methods: In these retrospective analyses we studied women treated for spontaneous fetal miscarriage with misoprostol-only (n = 24) or mifepristone and misoprostol (n = 177) in duration of gestation 12+1–21+6. Primary outcome...

  20. Prevalence and risk factors for urinary incontinence in pregnant women during late third trimester

    OpenAIRE

    Aruna Nigam; Ayesha Ahmad; Diksha Gaur; Arifa A. Elahi; Swaraj Batra

    2016-01-01

    Background: Urinary incontinence (UI) is defined as any involuntary urinary leakage by the International continence society (ICS). The objective of this study was to analyze the prevalence and risk factors of urinary incontinence in pregnant women in late third trimester. Methods: A questionnaire based survey done on 400 pregnant women in third trimester beyond 34 weeks of gestation. A pretested, semi structured questionnaire was used to enquire about demographic and personal information r...

  1. Hubungan Pengetahuan Ibu Hamil Trimester III Tentang Gizi Seimbang Selama Hamil Dengan Kejadian Bblr

    OpenAIRE

    Woro Tri Utami, Woro Tri Utami; Waqidil Hidayah, Waqidil Hidayah; Ika Junita, Ika Junita

    2013-01-01

    Knowledge of mothers on nutrition is crucial to the future of children and families. The purpose of the study to analyze the relationship of knowledge maternal 3rd trimester about balanced diet for pregnant with BBLR incident . Survey design used analytic approaches Prospective ( Cohort ) , sampling techniques using simple random sampling . Independent Variable knowledge maternal 3rd trimester about balanced nutrition and dependent variable BBLR incident . Instrument research questionnaires a...

  2. First Trimester Aneuploidy Screening Program for Preeclampsia Prediction in a Portuguese Obstetric Population

    OpenAIRE

    Teixeira, Cláudia; Tejera, Eduardo; Martins, Helena; Pereira, António Tomé; Costa-Pereira, Altamiro; Rebelo, Irene

    2014-01-01

    Objective. To evaluate the performance of a first trimester aneuploidy screening program for preeclampsia (PE) prediction in a Portuguese obstetric population, when performed under routine clinical conditions. Materials and Methods. Retrospective cohort study of 5672 pregnant women who underwent routine first trimester aneuploidy screening in a Portuguese university hospital from January 2009 to June 2013. Logistic regression-based predictive models were developed for prediction of PE based o...

  3. The effects of additives (MgO, La2O3 and Y2O3) in the translucency of alumina

    International Nuclear Information System (INIS)

    Genova, L.A.; Bressiani, A.H.A.; Bressiani, J.C.

    1993-01-01

    The effect of the addition of small amounts of Mg O, La 2 O 3 and Y 2 O 3 in the optical characteristics of the high purity alumina has been studied. Specimens with high transmittance in the visible region has been obtained. High purity alumina powders have also been obtained through the crystallization of ammonium alum. Translucent samples have been produced from these powders. (author). 6 refs, 5 figs, 4 tabs

  4. Model-based analysis of nonstationary thermal mode in premises with an insolation passive heating system with a three-layer translucent shield

    International Nuclear Information System (INIS)

    Avezova, N.R.; Avezov, R.R.; Rashidov, Y.K. et al.

    2014-01-01

    The results of the model-based study of nonstationary thermal mode in premises with an insolation passive heating system with a three-layer translucent shield are presented. The article is aimed at determining daily variations in the air temperature of the heated premise on typical heating season days and analyzing the optimization of the thermal capacity of the short-term (daily) thermal battery of the heating system on this basis. (author)

  5. Fabrication and characterization of millimeter-scale translucent La{sub 2}O{sub 3}-doped Al{sub 2}O{sub 3} ceramic hollow spheres

    Energy Technology Data Exchange (ETDEWEB)

    Li, Haoting [School of Material Science and Engineering, Southwest University of Science and Technology, Mianyang 621010, Sichuan (China); Liao, Qilong, E-mail: liaoqilong@swust.edu.cn [School of Material Science and Engineering, Southwest University of Science and Technology, Mianyang 621010, Sichuan (China); Dai, Yunya [School of Material Science and Engineering, Southwest University of Science and Technology, Mianyang 621010, Sichuan (China); Wang, Fu, E-mail: wfu2005@163.com [School of Material Science and Engineering, Southwest University of Science and Technology, Mianyang 621010, Sichuan (China); Wang, Haiyang [School of Material Science and Engineering, Southwest University of Science and Technology, Mianyang 621010, Sichuan (China); Li, Xibo [Research Center of Laser Fusion CAEP, Mianyang 621900, Sichuan (China)

    2016-04-15

    Highlights: • Millimeter-scale translucent La{sub 2}O{sub 3}-doped Al{sub 2}O{sub 3} hollow spheres have been prepared. • The diameters of the prepared hollow spheres are 500–1300μm. • The degree of sphericity for the prepared hollow spheres is above 98%. • The mechanisms of transparency are discussed. - Abstract: Millimeter-scale translucent La{sub 2}O{sub 3}-doped Al{sub 2}O{sub 3} ceramic hollow spheres have been successfully prepared using the oil-in-water (paraffin-in-alumina sol) droplets as precursors made by self-made T-shape micro-emulsion device. The main crystalline phase of the obtained hollow sphere is alpha alumina. The prepared translucent La{sub 2}O{sub 3}-containing Al{sub 2}O{sub 3} ceramic hollow spheres have diameters of 500–1300 μm, wall thickness of about 23 μm and the degree of sphericity of above 98%. With the increase of the La{sub 2}O{sub 3} content, grains and grain-boundaries of the alumina spherical shell for the prepared millimeter-scale hollow spheres become regular and clear gradually. When the La{sub 2}O{sub 3} content is 0.1 wt.%, the crystal surface of the obtained Al{sub 2}O{sub 3} spherical shell shows optimal grains and few pores, and its transmittance reaches 42% at 532 nm laser light. This method provides a promising technique of preparing millimeter-scale translucent ceramic hollow spheres for laser inertial confined fusion.

  6. Delays in seeking an abortion until the second trimester: a qualitative study in South Africa

    Directory of Open Access Journals (Sweden)

    Gabriel Mosotho

    2007-09-01

    Full Text Available Abstract Background Despite changes to the South African abortion legislation in 1996, barriers to women accessing abortions still exist. Second trimester abortions, an inherently more risky procedure, continue to be 20% of all abortions. Understanding the reasons why women delay seeking an abortion until the second trimester is important for informing interventions to reduce the proportion of second trimester abortions in South Africa. Methods Qualitative research methods were used to collect data. Twenty-seven in-depth interviews were conducted in 2006 with women seeking a second trimester abortion at one public sector tertiary hospital and two NGO health care facilities in the greater Cape Town area, South Africa. Data were analysed using a grounded theory approach. Results Almost all women described multiple and interrelated factors that influenced the timing of seeking an abortion. Reasons why women delayed seeking an abortion were complex and were linked to changes in personal circumstances often leading to indecision, delays in detecting a pregnancy and health service related barriers that hindered access to abortion services. Conclusion Understanding the complex reasons why women delay seeking an abortion until the second trimester can inform health care interventions aimed at reducing the proportion of second trimester abortions in South Africa.

  7. An analysis of posture and back pain in the first and third trimesters of pregnancy.

    Science.gov (United States)

    Franklin, M E; Conner-Kerr, T

    1998-09-01

    While the incidence of back pain during pregnancy has been shown to be high, few studies have investigated postural changes that occur during pregnancy and their relationship to back pain. The purpose of this study was to determine if posture and back pain changed from the first to the third trimester of pregnancy and whether there was a relationship between the two. Twelve healthy women who were having uncomplicated pregnancies participated in the study. During the first and third trimesters, each subject had their standing posture and back pain assessed by a Metrecom Skeletal Analysis System and a 0- to 10-cm line pain scale, respectively. Repeated measures analysis of variance and Pearson correlation coefficients were calculated on or between back pain and nine posture variables and revealed significant increases in third trimester back pain and postures compared with first trimester back pain (p postures for lumbar angle (p change in posture and back pain. These results suggest that in the standing position the lumbar lordosis and sagittal pelvic tilt increased and head position become more posterior as women progressed from the first trimester to the last trimester of pregnancy. These postural changes, however, were not related to back pain. This suggests that many of the posture-correcting clinical exercise regimens given to pregnant women need to be investigated.

  8. Ankle Proprioception Pattern in Women Across Various Trimesters of Pregnancy and Postpartum

    Directory of Open Access Journals (Sweden)

    Ramachandra P

    2016-01-01

    Full Text Available Background and Objectives: Ankle foot complex is the part of the body which is in contact with the ground and it is important to have an intact proprioceptive system in order to maintain postural control. Previous study has established that there is significant difference between ankle proprioception in pregnant women in their third trimester and non-pregnant women. There is lack of literature regarding when the ankle does the ankle proprioception gets affected during pregnancy and whether this change reverts back during postpartum and hence this study. Method: A cohort of 70 primiparous women were included in the study and the women were followed through 12th week, 24th week, 32nd week , immediate postpartum and 6 weeks postpartum. The ankle repositioning error was measured using photography method and was analyzed using UTHSCSA Image tool software. Repeated measures ANOVA was used to measure the differences across various time periods. Results: It was found that there was a significant differences (p<0.001 in ankle repositioning error in pregnant women across the trimesters and in the postpartum period and the value did not reach the first trimester value even after six weeks postpartum. Conclusion: Ankle proprioception was significantly affected across the various trimesters of pregnancy with the peak variability observed in the third trimester and the value did not reach back to the first trimester value even after 6 weeks postpartum.

  9. Establishment of Trimester-Specific Reference Intervals for Thyroid Hormones in Korean Pregnant Women

    Science.gov (United States)

    Moon, Hee-Won; Chung, Hee-Jung; Park, Chul-Min; Hur, Mina

    2015-01-01

    Background Establishment of trimester- and assay-specific reference intervals for every population is recommended. The aim of this study was to establish a trimester- and assay-specific reference interval for thyroid-stimulating hormone (TSH) and free thyroxine (FT4) in Korean pregnant women. Methods From April 2012 to December 2012, 531 pregnant women receiving prenatal care and 238 age-matched, non-pregnant women were enrolled in this study. After excluding patients with pregnancy-associated complications or thyroid-specific autoantibody, 465 pregnant and 206 non-pregnant women were included. Non-parametric analysis (2.5-97.5th percentile) was performed to determine the reference interval. Levels of TSH and FT4 were determined by electrochemiluminescence immunoassay (Elecsys thyroid tests, Roche Diagnostics, Germany). Results The TSH reference intervals were 0.01-4.10, 0.01-4.26, and 0.15-4.57 mIU/L for the first, second, and third trimester, respectively. From the first trimester to the third trimester, the median TSH levels showed a significantly increasing trend (Preference intervals were 0.83-1.65, 0.71-1.22, and 0.65-1.13 ng/dL for the first, second, and third trimester, respectively, showing a significantly decreasing trend (Preference intervals in pregnant women is essential for accurate assessment of thyroid function. Our population-specific and method-specific reference intervals will be useful for screening Korean pregnant women for thyroid disease. PMID:25729721

  10. Cervical dilation before first-trimester surgical abortion (<14 weeks' gestation).

    Science.gov (United States)

    Allen, Rebecca H; Goldberg, Alisa B

    2016-04-01

    First-trimester surgical abortion is a common, safe procedure with a major complication rate of less than 1%. Cervical dilation before suction abortion is usually accomplished using tapered mechanical dilators. Risk factors for major complications in the first trimester include increasing gestational age and provider inexperience. Cervical priming before first-trimester surgical abortion has been studied using osmotic dilators and pharmacologic agents, most commonly misoprostol. Extensive data demonstrate that a variety of agents are safe and effective at causing preoperative cervical softening and dilation; however, given the small absolute risk of complications, the benefit of routine use of misoprostol or osmotic dilators in first-trimester surgical abortion is unclear. Although cervical priming results in reduced abortion time and improved provider ease, it requires a delay of at least 1 to 3 h and may confer side effects. The Society of Family Planning does not recommend routine cervical priming for first-trimester suction abortion but recommends limiting consideration of cervical priming for women at increased risk of complications from cervical dilation, including those late in the first trimester, adolescents and women in whom cervical dilation is expected to be challenging. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Analytical prediction of sub-surface thermal history in translucent tissue phantoms during plasmonic photo-thermotherapy (PPTT).

    Science.gov (United States)

    Dhar, Purbarun; Paul, Anup; Narasimhan, Arunn; Das, Sarit K

    2016-12-01

    Knowledge of thermal history and/or distribution in biological tissues during laser based hyperthermia is essential to achieve necrosis of tumour/carcinoma cells. A semi-analytical model to predict sub-surface thermal distribution in translucent, soft, tissue mimics has been proposed. The model can accurately predict the spatio-temporal temperature variations along depth and the anomalous thermal behaviour in such media, viz. occurrence of sub-surface temperature peaks. Based on optical and thermal properties, the augmented temperature and shift of the peak positions in case of gold nanostructure mediated tissue phantom hyperthermia can be predicted. Employing inverse approach, the absorption coefficient of nano-graphene infused tissue mimics is determined from the peak temperature and found to provide appreciably accurate predictions along depth. Furthermore, a simplistic, dimensionally consistent correlation to theoretically determine the position of the peak in such media is proposed and found to be consistent with experiments and computations. The model shows promise in predicting thermal distribution induced by lasers in tissues and deduction of therapeutic hyperthermia parameters, thereby assisting clinical procedures by providing a priori estimates. Copyright © 2016 Elsevier Ltd. All rights reserved.

  12. Prenatal cytogenetic diagnosis in Spain: analysis and evaluation of the results obtained from amniotic fluid samples during the last decade.

    Science.gov (United States)

    Mademont-Soler, Irene; Morales, Carme; Clusellas, Núria; Soler, Anna; Sánchez, Aurora

    2011-08-01

    Chromosome abnormalities are one of the main causes of congenital defects, and establishing their frequency according to the different clinical indications for invasive procedure during pregnancy is especially important for genetic counselling. We analyzed the results of 29,883 amniotic fluid samples referred to our laboratory for cytogenetic studies from 1998 to 2009, which constitutes the largest series of cytogenetic analysis performed on amniotic fluid samples in Spain. The number of samples received tended to increase from 1998 to 2005, but after 2005 it decreased substantially. Cytogenetic results were obtained in 99.5% of the samples, and the detected incidence of chromosome abnormalities was 2.9%. Of these, 48.1% consisted of classical autosomal aneuploidies, trisomy 21 being the most frequent one. The main clinical indications for amniocentesis were positive prenatal screening and advanced maternal age, but referral reasons with highest positive predictive values were, excluding parental chromosome rearrangement, increased nuchal translucency (9.2%) and ultrasound abnormalities (6.6%). In conclusion, performing the karyotype on amniotic fluid samples is a good method for the detection of chromosome abnormalities during pregnancy. The number of cytogenetic studies on amniotic fluid has now decreased, however, due to the implementation of first trimester prenatal screening for the detection of Down syndrome, which allows karyotyping on chorionic villus samples. Our results also show that both ultrasound abnormalities and increased nuchal translucency are excellent clinical indicators for fetal chromosome abnormality. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  13. Third trimester ultrasound soft-tissue measurements accurately predicts macrosomia.

    Science.gov (United States)

    Maruotti, Giuseppe Maria; Saccone, Gabriele; Martinelli, Pasquale

    2017-04-01

    To evaluate the accuracy of sonographic measurements of fetal soft tissue in the prediction of macrosomia. Electronic databases were searched from their inception until September 2015 with no limit for language. We included only studies assessing the accuracy of sonographic measurements of fetal soft tissue in the abdomen or thigh in the prediction of macrosomia  ≥34 weeks of gestation. The primary outcome was the accuracy of sonographic measurements of fetal soft tissue in the prediction of macrosomia. We generated the forest plot for the pooled sensitivity and specificity with 95% confidence interval (CI). Additionally, summary receiver-operating characteristics (ROC) curves were plotted and the area under the curve (AUC) was also computed to evaluate the overall performance of the diagnostic test accuracy. Three studies, including 287 singleton gestations, were analyzed. The pooled sensitivity of sonographic measurements of abdominal or thigh fetal soft tissue in the prediction of macrosomia was 80% (95% CI: 66-89%) and the pooled specificity was 95% (95% CI: 91-97%). The AUC for diagnostic accuracy of sonographic measurements of fetal soft tissue in the prediction of macrosomia was 0.92 and suggested high diagnostic accuracy. Third-trimester sonographic measurements of fetal soft tissue after 34 weeks may help to detect macrosomia with a high degree of accuracy. The pooled detection rate was 80%. A standardization of measurements criteria, reproducibility, building reference charts of fetal subcutaneous tissue and large studies to assess the optimal cutoff of fetal adipose thickness are necessary before the introduction of fetal soft-tissue markers in the clinical practice.

  14. Screening for fetal chromosome abnormalities during the second trimester

    International Nuclear Information System (INIS)

    Dong Hui; Li Ming; Li Ping

    2005-01-01

    Objective: To develop a pre -natal screening program for fetal chromosome abnormalities based on risk values calculated from maternal serum markers levels during the second trimester. Methods: Serum levels of AFP, β-HCG, uE 3 were determined with CLIA in 1048 pregnant women during 14-21w gestation period and the results were analyzed with a specific software (screening program for Down' s syndrome developed by Beckman) for the risk rate. In those women defined as being of high risk rate, cells from amniotic fluid or umbilical cord blood were studied for karyotype analysis. Results: Of these 1048 women, 77 were designated as being of high risk rate for several chromosome abnormalities i.e. Down's syndrome, open spina bifida and trisomy -18 syndrome (overall positive rate 7.3%). Further fetal chromosome study in 31 of them revealed three proven cases of abnormality. Another cord blood study was performed in a calculated low risk rate case but with abnormal sonographic finding at 31 w gestation and proved to be abnormal (software study false negative). The remaining 46 high risk rate cases either refused future study (n=35) or were lost for follow-up (n=11). Fortunately, all the 35 women refused further study gave birth to normal babies without any chromosome abnormalities discovered on peripheral blood study. Besides, in a trial study, five high risk rate women were again evaluated a few weeks later but with tremendous difference between the results. Conclusion: The present program proves to be clinically useful but needs further study and revision. Many factors may influence the result of the analysis and the duration of gestation period in weeks should be as accurate as possible. At present, in order to avoid getting false negatives, we don't advise a second check in 'high risk' cases. (authors)

  15. The Effect of Ramadan Fasting On Neonatal Weight In Different Trimesters Of Pregnancy

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    nahid sarafraz

    2015-09-01

    Full Text Available Background and Objectives: several investigations have been done to evaluate the effect of Ramadan fasting on fetal and maternal health, which have all led to controversial results. The role of Ramadan fasting time in birth weight is still unclear. This study evaluated the effect of fasting at different periods of pregnancy on birth weight. Methods: 250 pregnant women fasting at least one day during Ramadan participated in this retrospective cohort study. Subjects were categorized into 3 groups, namely first trimester (n=112, second trimester (n=68 and third trimester (n=70 of pregnancy. Demographic and anthropometric data, obstetric history and history of Ramadan fasting were recorded. After delivery, neonatal birth weight was measured. The mean of weight and frequency of low birth weight in each group were calculated. Probable related factors of low birth weight of neonates with fasting mothers were evaluated. Results: The mean of birth weight in different groups of Ramadan fasting time in first, second and third trimester of pregnancy were 3411.52±529.88, 3214.57±463.56 and 3336.86±444.89 gr respectively, which had a statistically significant difference (p=0.03. Frequencies of low birth weight in different groups of Ramadan fasting time in first trimester was 8.9%, in second trimester 8.8% and in third trimester it was 7.1%, which had no statistically significant difference (p=0.9. Among all evaluated factors, only neonatal sex was related to low birth weight. Conclusion: Time of Ramadan fasting during pregnancy does not affect birth weight.

  16. A Systematic Review on Normative Values of Trimester-specific Thyroid Function Tests in Indian Women.

    Science.gov (United States)

    Kannan, Subramanian; Mahadevan, Shriraam; Sigamani, Alben

    2018-01-01

    Small cross-sectional studies are published on the trimester-specific normal ranges of thyrotropin and thyroxine levels in Indian women from various parts of the country. We sought to review the published literature on thyroid function tests in normal pregnant Indian women to see if the pooled data from various studies can define normative data and hypothyroidism in pregnancy. We retrieved 56 studies from online databases with detailed search using multiple search terms. Unanimously eight studies were finalized. Data of 2703 pregnant women (age 16-45 years; 966 were in the first trimester, 1072 in their second trimester, and 1037 women in their third trimester) were analyzed. All eight studies included singleton pregnancies from the northern and eastern part of India with seven studies being cross-sectional in nature. The exclusion criteria in all studies included those with historical/clinical evidence of thyroid dysfunction, those with family history of thyroid dysfunction, infertility and those with history of recurrent miscarriages (usually >3). Ultrasound evidence of thyroid disease, urinary iodine assessment, and thyroid antibodies were included as additional exclusion criteria in two, three, and four studies, respectively. None of the studies included the outcome of pregnancy as part of follow-up. As part of the pooled data analysis, the 5 th -95 th centile values of normal TSH extended from 0.09 to 6.65 IU/mL in the first trimester, 0.39-6.61 IU/mL in the second trimester, and 0.70-5.18 IU/mL in the third trimester. The FT4 levels (5 th -95 th centile values) extended from 8.24 to 25.74 pmol/L in the first trimester, 6.82-26.0 pmol/L, and 5.18-25.61 pmol/L in the third trimester. With due limitations imposed by the quality of the available studies, the current review suggests that upper normal limit of TSH values can extend up to 5-6 IU/mL in pregnancy.

  17. Establishment of trimester-specific reference range for thyroid hormones during pregnancy.

    Science.gov (United States)

    Nazarpour, Sima; Ramezani Tehrani, Fahimeh; Simbar, Masoumeh; Minooee, Sonia; Rahmati, Maryam; Mansournia, Mohammad Ali; Azizi, Fereidoun

    2018-03-01

    Physiological gestational changes are associated with alterations in thyroid function which require different biochemical interpretation from that of non-pregnant women and necessitate established pregnancy-specific reference ranges. We aimed to identify the trimester-specific ranges of thyroid markers in a healthy population of pregnant Iranian women. In this self-sequential study, data were extracted from The Tehran Thyroid and Pregnancy Study; a total of 314 women were tested during the 1st, 2nd and 3rd trimesters for serum levels of thyrotropin (TSH), thyroxine (T4), free thyroxine index (FT4I) and thyroid peroxidase antibody (TPOAb). Trimester-specific reference intervals for TSH, T4 and FT4I and first trimester reference range for TPOAb were estimated. The normal and modulus exponential-normal models were fitted by maximum likelihood using STATA software. The 2.5th and 97.5th percentiles of thyroid parameters were determined and used as reference intervals. Mean±SD age of participants was 26.8±5.2years. Estimated reference intervals for TSH, T4 and FT4I in the 1st, 2nd and 3rd trimesters corresponding to the 2.5th and 97.5th percentiles were 0.14-6.14, 0.43-4.64, 0.63-3.9μIU/ml; 78.01-215.19, 93.23-243.87, 89.61-211.37nmol/L; and 1.73-4.53, 1.96-5.64, 1.72-4.30, respectively. Reference interval for TPOAb in the 1st trimester was 1.40-38.02IU/mL. Median of TSH was low in the 1st trimester, and gradually increased until 2nd trimester, followed by a slight decrease onward. A decreasing trend in TSH levels was observed in higher centiles with advancing gestational age. This study provides trimester-specific reference ranges for some common thyroid markers among healthy Iranian women in an iodine sufficient area, to prevent biochemical misinterpretations during pregnancy. Copyright © 2018 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  18. No. 223-Content of a Complete Routine Second Trimester Obstetrical Ultrasound Examination and Report.

    Science.gov (United States)

    Cargill, Yvonne; Morin, Lucie

    2017-08-01

    To review the benefits of and requirements for a complete second trimester ultrasound and the documentation needed. A complete second trimester ultrasound provides information about the number of fetuses, the gestational age, the location of the placenta, and fetal and maternal anatomy. In the production of this document, the American Institute of Ultrasound in Medicine's "Practice Guideline for the Performance of Obstetric Ultrasound Examinations," the American College of Obstetricians and Gynecologists' practice bulletin, "Ultrasound in Pregnancy," and the Royal College of Obstetricians and Gynaecologists' Working Party Report, "Ultrasound Screening" were reviewed. PubMed and the Cochrane Database were searched using the words "routine second trimester obstetrical ultrasound." The evidence was evaluated using the guidelines developed by the Canadian Task Force on Preventive Health Care. A routine complete second trimester ultrasound between 18 and 22 weeks and a complete ultrasound report will provide the best opportunity to diagnose fetal anomalies and to assist in the management of prenatal care. It will also reduce the number of ultrasound examinations done during the second trimester for completion of fetal anatomy survey. The costs are those involved with the performance of obstetrical ultrasound. This is a revision of previous guidelines; information from other consensus reviews from medical publications has been used. The Society of Obstetricians and Gynaecologists of Canada. Copyright © 2017. Published by Elsevier Inc.

  19. The effects of isolated single umbilical artery on first and second trimester aneuploidy screening test parameters.

    Science.gov (United States)

    Tulek, Firat; Kahraman, Alper; Taskin, Salih; Ozkavukcu, Esra; Soylemez, Feride

    2015-04-01

    Reliability of first and second trimester screening tests largely depends on accurate estimation of maternal serum marker values. Reduced reliability could lead redundant invasive tests or misdiagnosis. Adjustments of serum marker values for confounding factors like insulin-dependent diabetes, maternal weight or maternal rhesus status are essential. We aimed to investigate whether isolated single umbilical artery alters first and second trimester test parameters or not. Routine detailed obstetric ultrasonographies performed were retrospectively screened for this study. Among spontaneously conceived singleton pregnancies, women who were found to have single umbilical artery without any additional structural anomalies or aneuploidies were selected. First and second trimester screening test results were accessible for 98 and 102 of the cases with isolated single umbilical artery, respectively. Among first trimester screening test parameters, PAPP-A (pregnancy-associated plasma protein A) MoMs were found significantly higher in isolated single umbilical artery group. AFP MoMs were found significantly elevated in isolated single umbilical artery group in second trimester quadruple tests. Existence of single umbilical artery could alter the estimation of MoM values of maternal serum markers. Reliability of prenatal screening tests could be improved by adjusting these parameters in accordance with isolated single umbilical artery.

  20. Risk and uncertainty: shifting decision making for aneuploidy screening to the first trimester of pregnancy.

    Science.gov (United States)

    Farrell, Ruth M; Dolgin, Natasha; Flocke, Susan A; Winbush, Victoria; Mercer, Mary Beth; Simon, Christian

    2011-05-01

    The clinical introduction of first trimester aneuploidy screening uniquely challenges the informed consent process for both patients and providers. This study investigated key aspects of the decision-making process for this new form of prenatal genetic screening. Qualitative data were collected by nine focus groups that comprised women of different reproductive histories (N = 46 participants). Discussions explored themes regarding patient decision making for first trimester aneuploidy screening. Sessions were audio recorded, transcribed, coded, and analyzed to identify themes. Multiple levels of uncertainty characterize the decision-making process for first trimester aneuploidy screening. Baseline levels of uncertainty existed for participants in the context of an early pregnancy and the debate about the benefit of fetal genetic testing in general. Additional sources of uncertainty during the decision-making process were generated from weighing the advantages and disadvantages of initiating screening in the first trimester as opposed to waiting until the second. Questions of the quality and quantity of information and the perceived benefit of earlier access to fetal information were leading themes. Barriers to access prenatal care in early pregnancy presented participants with additional concerns about the ability to make informed decisions about prenatal genetic testing. The option of the first trimester aneuploidy screening test in early pregnancy generates decision-making uncertainty that can interfere with the informed consent process. Mechanisms must be developed to facilitate informed decision making for this new form of prenatal genetic screening.

  1. Evaluation of shear bond strength and shear stress on zirconia reinforced lithium silicate and high translucency zirconia.

    Directory of Open Access Journals (Sweden)

    Amanda Maria de Oliveira Dal Piva

    2018-01-01

    Full Text Available This study evaluated the shear stress distribution on the adhesive interface and the bond strength between resin cement and two ceramics. For finite element analysis (FEA, a tridimensional model was made using computer-aided design software. This model consisted of a ceramic slice (10x10x2mm partially embedded on acrylic resin with a resin cement cylinder (Ø=3.4 mm and h=3mm cemented on the external surface. Results of maximum principal stress and maximum principal shear were obtained to evaluate the stress generated on the ceramic and the cylinder surfaces. In order to reproduce the in vitro test, similar samples to the computational model were manufactured according to ceramic material (Zirconia reinforced lithium silicate - ZLS and high translucency Zirconia - YZHT, (N=48, n=12. Half of the specimens were submitted to shear bond test after 24h using a universal testing machine (0.5 mm/min, 50kgf until fracture. The other half was stored (a (180 days, water, 37ºC prior to the test. Bond strength was calculated in MPa and submitted to analysis of variance. The results showed that ceramic material influenced bond strength mean values (p=0.002, while aging did not: YZHT (19.80±6.44a, YZHTa (17.95±7.21a, ZLS (11.88±5.40b, ZLSa (11.76±3.32b. FEA results showed tensile and shear stress on ceramic and cylinder surfaces with more intensity on their periphery. Although the stress distribution was similar for both conditions, YZHT showed higher bond strength values; however, both materials seemed to promote durable bond strength.

  2. Predisposing Factors to Abnormal First Trimester Placentation and the Impact on Fetal Outcomes

    Science.gov (United States)

    Kroener, Lindsay; Wang, Erica T.; Pisarska, Margareta D.

    2016-01-01

    Normal placentation during the first trimester sets the stage for the rest of pregnancy and involves a finely orchestrated cellular and molecular interplay of maternal and fetal tissues. The resulting intrauterine environment plays an important role in fetal programming and the future health of the fetus, and is impacted by multiple genetic and epigenetic factors. Abnormalities in placentation and spiral artery invasion can lead to ischemia, placental disease and adverse obstetrical outcomes including preeclampsia, intrauterine growth restriction, and placental abruption. Although first trimester placentation is affected my multiple factors, preconception environmental influences such as mode of conception, including assisted reproductive technologies which result in fertilization in vitro and intrauterine influences due to sex differences are emerging as potential significant factors impacting first trimester placentation. PMID:26696276

  3. First-Trimester Pregnancy Exposure to Venlafaxine or Duloxetine and Risk of Major Congenital Malformations

    DEFF Research Database (Denmark)

    Lassen, Dorte; Ennis, Zandra Nymand; Damkier, Per

    2016-01-01

    and noradrenaline reuptake inhibitors, SNRIs, significantly less data are available. Following the PRISMA guideline for systematic reviews, we performed a systematic search on the risk of major congenital malformations after first trimester in utero exposure to venlafaxine or duloxetine. We identified eight cohort.......92-1.35). The corresponding data for duloxetine were 668 infants and 16 major malformations, resulting in a relative risk estimate and 95% confidence interval of 0.80 (0.46-1.29). First-trimester in utero exposure to venlafaxine is not associated with an increased risk of major congenital malformations. The amount of data...... studies reporting on the outcome upon in utero exposure to venlafaxine or duloxetine during the first trimester. The cumulated data for venlafaxine were 3186 exposed infants and 107 major malformations, resulting in a relative risk estimate and 95% confidence interval of 1.12 (0...

  4. Analysis of sequential hair segments reflects changes in the metabolome across the trimesters of pregnancy

    DEFF Research Database (Denmark)

    Delplancke, Thibaut D J; de Seymour, Jamie V; Tong, Chao

    2018-01-01

    The hair metabolome has been recognized as a valuable source of information in pregnancy research, as it provides stable metabolite information that could assist with studying biomarkers or metabolic mechanisms of pregnancy and its complications. We tested the hypothesis that hair segments could...... be used to reflect a metabolite profile containing information from both endogenous and exogenous compounds accumulated during the nine months of pregnancy. Segments of hair samples corresponding to the trimesters were collected from 175 pregnant women in New Zealand. The hair samples were analysed using...... gas chromatography-mass spectrometry and liquid chromatography-mass spectrometry. In healthy pregnancies, 56 hair metabolites were significantly different between the first and second trimesters, while 62 metabolites were different between the first and third trimesters (p 

  5. Efficacy of Combination Therapy with Methotrexate and Misoprostol in Termination of Pregnancy in the First Trimester

    Directory of Open Access Journals (Sweden)

    Mohammad Taghi Shakeri

    2009-06-01

    Full Text Available Background: Induced abortion is the medical or surgical terminationof pregnancy before fetal viability. It has maternal orfetal indications. The aim of the present study was to evaluatethe efficacy of the combination of methotrexate and misoprostolfor termination of the pregnancy in the first trimester.Methods: This analytic study was performed on 100 women atthe first trimester of pregnancy (9 weeksand 24 has gestational age9 weeks and22 patients with gestational age <9 weeks had complete abortion.Failure rate was higher in missed abortion. Required doseof misoprostol and duration of conceptus expulsion werehigher in pregnancies with missed abortion.Conclusion: Combination therapy with methotrexate and misoprostolrepresents a safe and effective alternative to invasivemethods for termination of the pregnancy in the first trimester.

  6. Neonatal congenital lung tumors - the importance of mid-second-trimester ultrasound as a diagnostic clue

    Energy Technology Data Exchange (ETDEWEB)

    Waelti, Stephan L.; Garel, Laurent; Rypens, Francoise; Dubois, Josee [University of Montreal, Department of Medical Imaging, Sainte-Justine Hospital, Quebec (Canada); Dal Soglio, Dorothee [University of Montreal, Department of Pathology, Sainte-Justine Hospital, Quebec (Canada); Messerli, Michael [University Hospital Zurich, University of Zurich, Department of Nuclear Medicine, Zurich (Switzerland)

    2017-12-15

    The differential diagnosis for primary lung masses in neonates includes a variety of developmental abnormalities; it also consists of the much rarer congenital primary lung tumors: cystic pleuropulmonary blastoma (cystic PPB), fetal lung interstitial tumor (FLIT), congenital peribronchial myofibroblastic tumor (CPMT), and congenital fibrosarcoma. Radiologic differentiation between malformations and tumors is often very challenging. The objective was to establish distinctive features between developmental pulmonary abnormalities and primary lung tumors. We conducted a retrospective study of 135 congenital lung lesions at a university mother and child center over a period of 10 years (2005-2015). During this time, we noted four tumors (two cystic PPBs and two FLITs) and 131 malformations. We recorded the following parameters: timing of conspicuity in utero (mid-second trimester, third trimester, or not seen prenatally), presence of symptoms at birth, prenatal and perinatal radiologic findings, and either histological diagnoses by pathology or follow-up imaging in non-operated cases. All lesions except the four tumors were detected during mid-second-trimester ultrasound. In none of the tumors was any pulmonary abnormality found on the mid-second-trimester sonogram, contrary to the developmental pulmonary abnormalities. The timing of conspicuity in utero appears to be a key feature for the differentiation between malformations and tumors. Lesions that were not visible at the mid-second-trimester ultrasound should be considered as tumor. A cystic lung lesion in the context of a normal mid-second-trimester ultrasound is highly suggestive of a cystic PPB. Differentiating the types of solid congenital lung tumors based upon imaging features is not yet feasible. (orig.)

  7. Trimester specific reference intervals for thyroid function tests in normal Indian pregnant women

    Science.gov (United States)

    Sekhri, Tarun; Juhi, Juhi Agarwal; Wilfred, Reena; Kanwar, Ratnesh S.; Sethi, Jyoti; Bhadra, Kuntal; Nair, Sirimavo; Singh, Satveer

    2016-01-01

    Context: Accurate assessment of thyroid function during pregnancy is critical, for initiation of thyroid hormone therapy, as well as for adjustment of thyroid hormone dose in hypothyroid cases. Aims: We evaluated pregnant women who had no past history of thyroid disorders and studied their thyroid function in each trimester. Settings and Design: 86 normal pregnant women in the first trimester of pregnancy were selected for setting reference intervals. All were healthy, euthyroid and negative for thyroid peroxidase antibody (TPOAb). These women were serially followed throughout pregnancy. 124 normal nonpregnant subjects were selected for comparison. Material and methods: Thyrotropin (TSH), free thyroxine (FT4), free triiodothyronine (FT3) and anti-TPO were measured using Roche Elecsys 1010 analyzer. Urinary iodine content was determined by simple microplate method. The 2.5th and 97.5th percentiles were calculated as the reference intervals for thyroid hormone levels during each trimester. Statistical Analysis: SPSS (version 14.0, SPSS Inc., Chicago, IL, USA) was used for data processing and analysis. Results: The reference intervals for the first, second and third trimesters for the following parameters: TSH 0.09-6.65, 0.51-6.66, 0.91-4.86 µIU/mL, FT4 9.81-18.53, 8.52-19.43, 7.39-18.28 pM/L and FT3 3.1-6.35, 2.39-5.12, 2.57-5.68 pM/L respectively. Thyroid hormone concentrations significantly differed during pregnancy at different stages of gestation. The pregnant women in the study had median urinary iodine concentration of 150-200 µg/l during each trimester. Conclusions: The trimester-specific reference intervals for thyroid tests during pregnancy have been established for pregnant Indian women serially followed during pregnancy using 2.5th and 97.5th percentiles. PMID:26904477

  8. Maternal age during pregnancy is associated with third trimester blood pressure level: the generation R study.

    Science.gov (United States)

    Gaillard, Romy; Bakker, Rachel; Steegers, Eric A P; Hofman, Albert; Jaddoe, Vincent W V

    2011-09-01

    We hypothesized that hemodynamic adaptations related to pregnancy and ageing might be associated with differences in blood pressure levels during pregnancy between younger and older women. This might partly explain the increased risk of gestational hypertensive disorders with advanced maternal age. We examined the associations of maternal age with systolic and diastolic blood pressure in each trimester of pregnancy and the risks of gestational hypertensive disorders. The study was conducted among 8,623 women participating in a population-based prospective cohort study from early pregnancy onwards. Age was assessed at enrolment. Blood pressure was measured in each trimester. Information about gestational hypertensive disorders was available from medical records. In second and third trimester, older maternal age was associated with lower systolic blood pressure (-0.9 mm Hg (95% confidence interval: -1.4, -0.3) and -0.6 mm Hg (95% confidence interval: -1.1, -0.02) per additional 10 maternal years, respectively). Older maternal age was associated with higher third trimester diastolic blood pressure (0.5 mm Hg (95% confidence interval: 0.04, 0.9) per additional 10 maternal years). Maternal age was associated with pregnancy-induced hypertension among overweight and obese women. Older maternal age is associated with lower second and third trimester systolic blood pressure, but higher third trimester diastolic blood pressure. These blood pressure differences seem to be small and within the physiological range. Maternal age is not consistently associated with the risks of gestational hypertensive disorders. Maternal body mass index might influence the association between maternal age and the risk of pregnancy-induced hypertension.

  9. Neonatal congenital lung tumors - the importance of mid-second-trimester ultrasound as a diagnostic clue

    International Nuclear Information System (INIS)

    Waelti, Stephan L.; Garel, Laurent; Rypens, Francoise; Dubois, Josee; Dal Soglio, Dorothee; Messerli, Michael

    2017-01-01

    The differential diagnosis for primary lung masses in neonates includes a variety of developmental abnormalities; it also consists of the much rarer congenital primary lung tumors: cystic pleuropulmonary blastoma (cystic PPB), fetal lung interstitial tumor (FLIT), congenital peribronchial myofibroblastic tumor (CPMT), and congenital fibrosarcoma. Radiologic differentiation between malformations and tumors is often very challenging. The objective was to establish distinctive features between developmental pulmonary abnormalities and primary lung tumors. We conducted a retrospective study of 135 congenital lung lesions at a university mother and child center over a period of 10 years (2005-2015). During this time, we noted four tumors (two cystic PPBs and two FLITs) and 131 malformations. We recorded the following parameters: timing of conspicuity in utero (mid-second trimester, third trimester, or not seen prenatally), presence of symptoms at birth, prenatal and perinatal radiologic findings, and either histological diagnoses by pathology or follow-up imaging in non-operated cases. All lesions except the four tumors were detected during mid-second-trimester ultrasound. In none of the tumors was any pulmonary abnormality found on the mid-second-trimester sonogram, contrary to the developmental pulmonary abnormalities. The timing of conspicuity in utero appears to be a key feature for the differentiation between malformations and tumors. Lesions that were not visible at the mid-second-trimester ultrasound should be considered as tumor. A cystic lung lesion in the context of a normal mid-second-trimester ultrasound is highly suggestive of a cystic PPB. Differentiating the types of solid congenital lung tumors based upon imaging features is not yet feasible. (orig.)

  10. Can leukocyte count during the first trimester of pregnancy predict later gestational complications?

    Science.gov (United States)

    Tzur, Tamar; Weintraub, Adi Y; Sergienko, Ruslan; Sheiner, Eyal

    2013-03-01

    To examine whether an association exists between maternal leukocyte count in the first trimester of pregnancy and the risk for development of obstetric complications. The study population included all the registered births (n = 33,866) with available white blood cell count (WBC) from the first trimester of pregnancy, during 2000-2010 in a tertiary medical center. The leukocyte count was sorted by the following groups: WBC 13.8 10 × 9/l. These groups were compared regarding obstetrical characteristics and perinatal outcomes. Multiple logistic regression models were used to control for confounders. The study population included 33,866 deliveries, of these 0.94 % had leukocytosis WBC > 13.8 10 × 9/l. Women with leukocytosis delivered significantly earlier, were more likely to be Jewish, and in their first pregnancy. There were significantly higher rates of preterm delivery before 37 weeks, fertility treatments, hypertensive disorders, gestational diabetes mellitus, and cesarean section among these patients. There was no significant difference between the groups regarding preterm premature rupture of membranes (PPROM) and chorioamnionitis. Women with leukocytosis during the first trimester had significantly higher rates of fetuses who were small for gestational age and with birth weight <2,500 g. Multivariable analysis showed a significant association between preterm delivery before 37 weeks and leukocytosis during the first trimester of pregnancy (p = 0.003). Leukocytosis during the first trimester is significantly associated with an increased risk for obstetrical complications, in particular preterm delivery. Nevertheless, further studies should focus on women with leukocytosis during the first trimester in order to verify our results.

  11. Screening for Fetal Spina Bifida Aperta by the Ultrasound and Intracranial Translucency Examinations at 11-13(+6) Weeks of Gestation.

    Science.gov (United States)

    Liu, Min; Liu, Ying; Li, Zhi-Hong; Yu, Ding

    2015-06-01

    The objective of the study is to evaluate the clinical significance of screening for fetal spina bifida aperta by ultrasound examination and intracranial translucency (IT) measurement at 11-13(+6) weeks of gestation. About 1,479 women at 11-13(+6) weeks of gestation in our hospital in 2012 were included as observation group, and 1,608 women at 11-13(+6) weeks of gestation without IT measurement in 2011 was included as controls. Detection rates of fetal spina bifida aperta in two groups were compared. The translucency thickness between the brain stem and choroid plexus and crown-rump length (CRL) in mid-sagittal view of the fetal face was measured, and translucency thickness and CRL in fetuses with spina bifida and healthy ones were compared. Detection rate of fetal spina bifida aperta in observation group was significantly higher than that in control group (six cases in observation group and one case in control group, p = 0.046). IT thickness was significantly lower in fetuses with spina bifida aperta (0.01 ± 1.25 mm) than that in healthy ones (1.73 ± 0.32 mm) (p spina bifida aperta (r = 0.001, p = 0.081). Ultrasound examination with IT measurement at 11-13(+6) weeks of gestation can be used to screen for fetal spina bifida aperta, and the reduction of IT thickness is an indicator of spina bifida aperta.

  12. Normative Trimester-Specific Thyroid Function Data from India: The State of the Nation.

    Science.gov (United States)

    Kannan, Subramanian; Kalra, Sanjay

    2018-01-01

    International guidelines recommend using local trimester-specific normative data for TSH (thyroid stimulating hormone). However, there are no unified Indian data for the same. This review collates recently published data from various Indian centres and discusses the state of trimester-specific TSH ranges in the country. The authors describe the strengths and limitations of available data, and support the need for pan-India data. To ensure effective screening and action, harmonized research is necessary to establish national normative data for TSH in India.

  13. First-trimester multimarker prediction of gestational diabetes mellitus using targeted mass spectrometry

    DEFF Research Database (Denmark)

    Ravnsborg, Tina; Andersen, Lise Lotte T; Trabjerg, Natacha D.

    2016-01-01

    perinatal outcome, no single protein biomarker has yet proven useful for this purpose. In the present study, we hypothesised that multimarker panels of serum proteins can improve first-trimester prediction of GDM among obese and non-obese women compared with single markers. Methods: A nested case......–control study was performed on first-trimester serum samples from 199 GDM cases and 208 controls, each divided into an obese group (BMI ≥27 kg/m2) and a non-obese group (BMI 2). Based on their biological relevance to GDM or type 2 diabetes mellitus or on their previously reported potential as biomarkers...

  14. Adiponectin and leptin as first trimester markers for gestational diabetes mellitus

    DEFF Research Database (Denmark)

    Thagaard, Ida Näslund; Krebs, Lone; Holm, Jens Christian

    2017-01-01

    Background: Gestational diabetes mellitus (GDM) is increasing partly due to the obesity epidemic. Adipocytokines have thus been suggested as first trimester screening markers for GDM. In this study we explore the associations between body mass index (BMI) and serum concentrations of adiponectin......, leptin, and the adiponectin/leptin ratio. Furthermore, we investigate whether these markers can improve the ability to screen for GDM in the first trimester. Methods: A cohort study in which serum adiponectin and leptin were measured between gestational weeks 6+0 and 14+0 in 2590 pregnant women...

  15. Program of complex rehabilitation of pregnant with alimentary-constitutional obesity in the third trimester.

    Directory of Open Access Journals (Sweden)

    Kovalenko T.N.

    2011-03-01

    Full Text Available In the article is presented the complex rehabilitation program for pregnant with alimentary-constitutional obesity in the third trimester. The program is directed on the decline of bodyweight, with the purpose of increase of scray-protective reactions of organism of pregnant and to the decline of obstetric traumatism in births. In an experiment took part 90 pregnant of the third trimester with obesity of I-III degree, middle genesial age. The developed and inculcated program foresaw the use of physical, psychological and medical rehabilitation.

  16. Low PAPP-A in the first trimester is associated with reduced fetal growth rate prior to gestational week 20

    DEFF Research Database (Denmark)

    Salvig, J D; Kirkegaard, I; Winding, Trine Nøhr

    2010-01-01

    To evaluate the association between maternal pregnancy-associated plasma protein-A (PAPP-A) and fetal growth from the first to the second trimester.......To evaluate the association between maternal pregnancy-associated plasma protein-A (PAPP-A) and fetal growth from the first to the second trimester....

  17. A double-blind randomized study of the effect of erythromycin in preventing pelvic inflammatory disease after first trimester abortion

    DEFF Research Database (Denmark)

    Sørensen, Jette Led; Thranov, I; Hoff, G

    1992-01-01

    To assess the prophylactic use of erythromycin in prevention of post-abortal pelvic inflammation disease (PID) in first trimester abortion.......To assess the prophylactic use of erythromycin in prevention of post-abortal pelvic inflammation disease (PID) in first trimester abortion....

  18. [Pregnancy intention and pregnancy-related anxiety in the second and third trimester: a birth cohort study].

    Science.gov (United States)

    You, Y; Yan, S Q; Huang, K; Mao, L J; Zhou, S S; Ge, X; Hao, J H; Zhu, P; Tao, F B

    2017-09-10

    Objective: To understand the association between pregnancy intention and pregnancy-related anxiety in the second and third trimester and its strength. Methods: A prospective cohort study was conducted in Ma'anshan, Anhui province. A total of 3 474 eligible pregnant women within 14 weeks of gestation were recruited. The information about their demographic characteristics were collected in early pregnancy. The completed questionnaire of pregnancy-related anxiety were asked to return in the second and third trimester. Logistic regression analysis was conducted to evaluate the association between pregnancy intention and pregnancy-related anxiety in the second and third trimester. Results: A total of 3 083 pregnant women were included in final analysis, The rate of unintentional pregnancy was 15.00 % ( n =461). The detection rates of pregnancy-related anxiety in the second and third trimester were 29.13 % ( n =898) and 30.36 % ( n =936). After controlling potential confounding factors, unintentional pregnancy increased the risk of pregnancy-related anxiety in the second trimester compared with intentional pregnancy ( OR =1.85, 95 %CI : 1.44-2.38); The risk of pregnancy-related anxiety also increased in the third trimester ( OR =1.84, 95 %CI : 1.44-2.35). Intentional pregnancy did not increase the risk of pregnancy-related anxiety in the second and third trimester. Conclusion: The study results suggests that unintentional pregnancy could increase the risk of pregnancy-related anxiety in the second and third trimester.

  19. Maternal obesity is not associated with increased crown-rump length in first-trimester ultrasounds of singleton gestations.

    Science.gov (United States)

    Gordon, Geoffrey H; Antony, Kathleen M; Sampene, Emmanuel; Iruretagoyena, Jesus Igor

    2018-02-20

    To evaluate whether or not obesity affects fetal growth in the first trimester of pregnancy. A retrospective cohort study of obese versus non-obese women in our ultrasound database was performed to compare crown-rump length (CRL), a surrogate of fetal growth, at the first-trimester genetic screening. A total of 50 obese and 50 non-obese women were included. CRL for both groups was performed at an average of 12wk5d ± 3 d. A linear regression analysis demonstrated that there was no difference between the cohorts in respect to CRL in the first trimester (p = .482). However, the estimated fetal weight at second-trimester anatomy ultrasound and the neonatal birth weight were increased in obese women (p < .001 for both analyses). Maternal obesity does not significantly alter the fetal CRL. However, maternal obesity appears to be associated with increased fetal growth as early as the second trimester.

  20. Translucence in dental prosthesis based on zirconia ceramics: effect of the sintering parameters; Translucidez em proteses dentarias a base de zirconia estabilizada com itria: efeito dos parametros de sinterizacao

    Energy Technology Data Exchange (ETDEWEB)

    Santos, C., E-mail: claudinei@demar.eel.usp.br [Universidade de Sao Paulo (USP), Lorena, SP (Brazil). Escola de Engenharia; Costa, L.; Habibe, R.H.; Souza, J.V.C.; Habibe, C.H. [Centro Universitario de Volta Redonda (MeMAT/UNIFOA), RJ (Brazil). Pro-Reitoria de Pesquisa e Extensao; Silva, O.M.M. [Centro Tecnico Aeroespacial (CTA/IAE/AMR), Sao Jose dos Campos, SP (Brazil)

    2011-07-01

    In this work the translucence of Zirconia dental ceramics was evaluated as function of sintering conditions (temperature and isothermal holding time). Samples with 15x15x1mm, were sintered at 1450 to 1600 deg C, with holding of 2h or 4h. Sintered samples were characterized by relative density, crystalline phases and microstructural aspects. Full density was obtained in samples sintered at 1530 and 1600 deg C, which presented higher grain sizes. Na increasing of translucence was observed in samples sintered at 1530 and 1600, correlating these properties with increasing of density and grain size of the samples. (author)

  1. Left ventricle shortening fraction: a comparison between euploid and trisomy 21 fetuses in the first trimester

    Czech Academy of Sciences Publication Activity Database

    Calda, P.; Břešťák, M.; Tomek, V.; Ošťádal, Bohuslav; Sonek, J.

    2010-01-01

    Roč. 30, č. 4 (2010), s. 368-371 ISSN 0197-3851 R&D Projects: GA MŠk(CZ) 1M0510 Institutional research plan: CEZ:AV0Z50110509 Keywords : trisomy 21 * first trimester * shortening fraction of the left ventricle Subject RIV: FA - Cardiovascular Diseases incl. Cardiotharic Surgery Impact factor: 2.152, year: 2010

  2. 78 FR 76759 - Fisheries of the Northeastern United States; Northeast Multispecies Fishery; Trimester Closure...

    Science.gov (United States)

    2013-12-19

    .... 120109034-2171-01] RIN 0648-XD024 Fisheries of the Northeastern United States; Northeast Multispecies Fishery; Trimester Closure for the Common Pool Fishery AGENCY: National Marine Fisheries Service (NMFS... INFORMATION CONTACT: Liz Sullivan, Fishery Management Specialist, 978-282-8493, Fax 978-281-9135...

  3. Selective serotonin reuptake inhibitor antidepressant use in first trimester pregnancy and risk of congenital anomalies

    DEFF Research Database (Denmark)

    Wemakor, A.; Casson, K.; Garne, E.

    2015-01-01

    % confidence intervals (CI) were calculated adjusted for registry. Results SSRI use in first trimester pregnancy was associated with CHD overall (OR 1.38, 95 % CI 1.05-1.82, n=109); and with severe CHDs (OR 1.56, 95 % CI 1.03-2.38, n=29). Specific associations between SSRI and Tetralogy of Fallot (OR 3.36, 95...

  4. Medical First-Trimester Termination of Pregnancy with Massive Fibroid Uterus

    Directory of Open Access Journals (Sweden)

    Michael Saad-Naguib

    2017-01-01

    Full Text Available First-trimester termination of pregnancy by medical or surgical route is highly effective with a low complication rate. Uterine abnormalities can complicate a procedure due to distortion of normal anatomy. In this case presentation, medical termination of pregnancy is performed using fetal intracardiac potassium chloride injection and intramuscular methotrexate.

  5. Placenta percreta causing acute abdomen in the second trimester of pregnancy

    International Nuclear Information System (INIS)

    Hussain, M.; Bhutta, S. Z.; Sarwar, S.

    2004-01-01

    Two cases of acute abdomen due to haemoperitoneum caused by placenta percreta in the second trimester are presented. Both had a history of previous lower segment caesarean section, a factor well-known to predispose the condition. How- ever, the rarity of the condition, presenting in mid pregnancy makes diagnosis and management difficult. Optimum ways of management are discussed. (author)

  6. Preterm delivery in women with low PAPP-A at first trimester screening

    Directory of Open Access Journals (Sweden)

    Razieh Mohamad Jafari

    2014-10-01

    Conclusion: We found high frequency of preterm delivery in pregnant women with low PAPP-A level at the first trimester screening. Hence, this group of patients needs special and early preventive management. Furthermore, we suggest that future researches to be conducted with larger sample size and also cervix length measurement to be included.

  7. Pengetahuan Ibu Hamil Trimester III Tentang KB Pasca Persalinan di Puskesmas Jetis Kota, Yogyakarta

    Directory of Open Access Journals (Sweden)

    Nining Kurnia

    2015-03-01

    Full Text Available The population of Indonesia increased every year. The goverment makes family planning post delivery to press off Indonesian growth. In Yogyakarta family planning post delivery were used by 527 people, at Puskesmas Jetis were 167 women from 363 total target of pregnant women. A succession of this program influenced by knowledge and education. The purpose of this study was to know the knowledge level of pregnant women in trimester III about family planning post delivery at Puskesmas Jetis Yogyakarta. The methode of this study was descriptive quantitative with cross sectional design. The sample obtained by saturated sampling technique which consisted of 45 pregnant women trimester III. The data used univariate analysys. The results showed that most of pregnants women in trimester III was aged 20-35 years (77.7%, high school education (37.8%, and there was 51.1% of pregnant women in fair knowledge level. Most of pregnant women decides to used family planning injection post delivery (44.4%. In conclusion, the knowledge level of pregnant women in trimester III about family planning post delivery was mostly in fair knowledge level.

  8. Maternal urinary beta-core hCG in chromosomally abnormal pregnancies in the first trimester

    NARCIS (Netherlands)

    Kornman, LH; Morssink, LP; Wortelboer, MJM; Beekhuis, [No Value; DeWolf, BTHM; Pratt, JJ; Mantingh, A

    We evaluated urinary beta-core human chorionic gonadotropin (beta-core hCG) in the detection of fetal Down's syndrome (DS) in the first trimester of pregnancy. Urine was collected prior to performing chorionic villous sampling (CVS) between 10 and 12 completed weeks from the last menstrual period.

  9. Vitamin D status in the first-trimester: effects of Vitamin D deficiency ...

    African Journals Online (AJOL)

    Objective: To assess serum levels of 25-hydroxyvitamin D [25(OH)D] in the first trimester and to determine the factors affecting deficiency levels and its association with pregnancy outcomes. Methods: Serum 25(OH)D concentrations were measured at 11-14 weeks' gestation in 229 singleton pregnancies using liquid ...

  10. Rituximab administration in third trimester of pregnancy suppresses neonatal B-cell development

    NARCIS (Netherlands)

    Klink, D. T.; van Elburg, R. M.; Schreurs, M. W. J.; van Well, G. T. J.

    2008-01-01

    We describe the effect on the neonate of administration of rituximab to a woman with idiopathic thrombocytopenic purpura (ITP). Rituximab, an anti-CD20 antibody, was given weekly for 4 weeks to a woman with ITP in her third trimester of pregnancy. One month after the last rituximab administration a

  11. Laparoscopy in the second and third trimesters of pregnancy for abdominal surgical emergencies.

    Science.gov (United States)

    Guterman, S; Mandelbrot, L; Keita, H; Bretagnol, F; Calabrese, D; Msika, S

    2017-05-01

    To assess complications and outcomes of pregnancies following laparoscopic abdominal surgery during the second and third trimesters of pregnancy. Retrospective single-center study of 23 cases of laparoscopic surgery in the second or third trimesters of pregnancy between January 2005 and May 2016. The laparoscopies were performed between 15 and 33 weeks of gestation, a mean of 23 weeks+2 days, with 6 cases in the 3rd trimester. The operations were: 11 cholecystectomies, 6 appendectomies, 1 intestinal occlusion (volvulus on a gastric band), 3 adnexal torsions, 1 ovarian cyst and 1 paratubal cyst with torsion. No secondary laparotomy was required. The postoperative courses were favorable in most cases. However, 3 appendectomies were complicated, one by chorioamnionitis and miscarriage at 20½ weeks of gestation and 2 by right iliac fossa abscesses requiring percutaneous radiological drainage, one of these women delivered a healthy term baby and the other had chorioamnionitis and preterm delivery at 34 weeks, followed by neonatal death. Laparoscopy can be safely performed for surgical indications in the second and third trimesters of pregnancy. In case of abdominal symptoms, a timely diagnosis is required to decide whether or not to operate and imaging should not be withheld particularly in case of suspected appendicitis which has a high risk of complications. Copyright © 2017. Published by Elsevier Masson SAS.

  12. Comparison of two dose regimens of misoprostol for second-trimester pregnancy termination

    NARCIS (Netherlands)

    Brouns, Joseph Franciscus Gertrudis Maria; van Wely, Madelon; Burger, Mattheus Petrus Maria; van Wijngaarden, Willem Jacobus

    2010-01-01

    Objective: The study was conducted to compare the efficacy of two different dose regimens of misoprostol administered vaginally in combination with mifepristone for second trimester termination of viable and non-viable pregnancies. Design: Double-blind randomized controlled trial conducted at the

  13. Actualization regarding genetic sonographic markers in the 1 trimester of pregnancy

    International Nuclear Information System (INIS)

    Trull Martinez, Felicia Amaralis; Pimentel Benitez, Hector; Garcia Borrego, Aniorland; Medina Ali, Frank Ernesto

    2010-01-01

    The topic of sonographic markers in the first trimester of pregnancy is reviewed, in order to provide an update. The predictive markers on the most frequent congenital anomalies are emphasized. It was concluded with important aspects that should be considered for a correct interpretation of these findings

  14. Maternal leptin and body composition in the first trimester of pregnancy.

    LENUS (Irish Health Repository)

    Fattah, Chro

    2012-02-01

    BACKGROUND: Leptin is produced mainly by adipocytes. Levels are increased in women with obesity and during pregnancy. Increased levels are also associated with pregnancy complications such as, pre-eclampsia and gestational diabetes mellitus. OBJECTIVE: We studied what component of body composition correlated best with maternal leptin in the first trimester of pregnancy and, whether maternal leptin correlated better with visceral fat rather than fat distributed elsewhere. SUBJECTS AND METHODS: Women were recruited in the first trimester. Maternal adiposity was measured using body mass index and advanced bioelectrical impedance analysis. Maternal leptin was measured using an enzyme-linked immunosorbent assay technique. RESULTS: Of the 100 subjects studied, the mean leptin concentration was 37.7 ng\\/ml (range: 2.1-132.8). Leptin levels did not correlate with gestational age in the first trimester, maternal age, parity or birth weight. Serum leptin correlated positively with maternal weight and body mass index, and with the different parameters of body composition. On multiple regression analysis, serum leptin correlated with visceral fat but not fat distributed elsewhere. CONCLUSIONS: Visceral fat is the main determinant of circulating maternal leptin in the first trimester of pregnancy. This raises the possibility that maternal leptin in early pregnancy may be a marker for the development of metabolic syndrome, including diabetes mellitus.

  15. Facial profile markers in second- and third-trimester fetuses with trisomy 18

    NARCIS (Netherlands)

    Vos, F. I.; De Jong-Pleij, E. A P; Bakker, M.; Tromp, E.; Manten, G. T R; Bilardo, C. M.

    2015-01-01

    Objectives To evaluate nasal bone length (NBL), maxilla-nasion-mandible (MNM) angle, fetal profile (FP) line, prenasal thickness (PT), prenasal thickness to nasal bone length (PT:NBL) ratio and prefrontal space ratio (PFSR) as markers of trisomy 18 in the second and third trimesters of pregnancy.

  16. Maternal weight and body composition in the first trimester of pregnancy.

    LENUS (Irish Health Repository)

    Fattah, Chro

    2012-02-01

    OBJECTIVE: Previous studies on weight gain in pregnancy suggested that maternal weight on average increased by 0.5-2.0 kg in the first trimester of pregnancy. This study examined whether mean maternal weight or body composition changes in the first trimester of pregnancy. DESIGN: Prospective observational study. POPULATION: We studied 1,000 Caucasian women booking for antenatal care in the first trimester of pregnancy. SETTING: Large university teaching hospital. METHODS: Maternal height and weight were measured digitally in a standardized way and Body Mass Index (BMI) was calculated. Maternal body composition was measured using segmental multifrequency Bioelectrical Impedance Analysis (BIA). Sonographic examination confirmed the gestational age and a normal ongoing singleton pregnancy in all subjects. MAIN OUTCOME MEASURES: Maternal weight, maternal body composition. RESULTS: The mean BMI was 25.7 kg\\/m(2) and 19.0% of the women were in the obese category (> or =30.0 kg\\/m(2)). Cross-sectional analysis by gestational age showed that there was no change in mean maternal weight, BMI, total body water, fat mass, fat-free mass or bone mass before 14 weeks gestation. CONCLUSIONS: Contrary to previous reports, mean maternal weight and mean body composition values remain unchanged in the first trimester of pregnancy. This has implications for guidelines on maternal weight gain during pregnancy. We also recommend that calculation of BMI in pregnancy and gestational weight gain should be based on accurate early pregnancy measurements, and not on self-reported or prepregnancy measurements.

  17. Alcohol reduction in the first trimester is unrelated to smoking, patient or pregnancy characteristics

    Directory of Open Access Journals (Sweden)

    Kristen A. Schmidt

    2017-06-01

    Conclusions: Women reported reducing their alcohol consumption during pregnancy, including those screening positive for pre-pregnancy problem drinking. First trimester alcohol reduction cannot be accounted for by smoking, patient or pregnancy characteristics; public health initiatives, psychological factors and hormonal mechanisms may be implicated.

  18. Reduced third-trimester levels of soluble human leukocyte antigen G protein in severe preeclampsia.

    Science.gov (United States)

    Hackmon, Rinat; Koifman, Arie; Hyodo, Hironobu; Hyobo, Hirohito; Glickman, Hagit; Sheiner, Eyal; Geraghty, Daniel E

    2007-09-01

    Recently, lower maternal plasma human leukocyte antigen (HLA)-G protein levels in preeclampsia (PE) in the first and second trimester was reported. Thus, we sought to evaluate the levels of HLA-G protein in patients with severe PE during the third trimester. In this prospective case control study, amniotic fluid and maternal and cord blood samples were aspirated from 50 pregnant women during the third trimester. The study group included 26 pregnant women diagnosed with severe PE and 24 women without PE serving as controls. A soluble HLA-G-specific enzyme-linked immunosorbent assay was used to measure protein levels. Statistical analysis included the Student t test and simple regression analysis. Maternal serum HLA-G levels in PE pregnancies were found to be significantly lower as compared with normal pregnancies (10.97 +/- 6.55 vs 36.05 +/- 34.53 microg/mL; P = .003). A reduced level of maternal HLA-G protein was associated with severe PE during the third trimester. This finding may suggest an essential role for HLA-G in normal and preeclamptic pregnancies.

  19. Pertussis Antibody Transfer to Preterm Neonates After Second- Versus Third-Trimester Maternal Immunization.

    Science.gov (United States)

    Eberhardt, Christiane S; Blanchard-Rohner, Geraldine; Lemaître, Barbara; Combescure, Christophe; Othenin-Girard, Véronique; Chilin, Antonina; Petre, Jean; Martinez de Tejada, Begoña; Siegrist, Claire-Anne

    2017-04-15

    Preterm infants are most vulnerable to pertussis. Whether they might benefit from maternal immunization is unknown. Extending our previous results in term neonates, this observational study demonstrates that second- rather than third-trimester maternal vaccination results in higher birth anti-pertussis toxin titers in preterm neonates. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

  20. Pertussis Antibody Transfer to Preterm Neonates After Second- Versus Third-Trimester Maternal Immunization

    OpenAIRE

    Eberhardt, Christiane S.; Blanchard-Rohner, Geraldine; Lema?tre, Barbara; Combescure, Christophe; Othenin-Girard, V?ronique; Chilin, Antonina; Petre, Jean; Martinez de Tejada, Bego?a; Siegrist, Claire-Anne

    2017-01-01

    Abstract Preterm infants are most vulnerable to pertussis. Whether they might benefit from maternal immunization is unknown. Extending our previous results in term neonates, this observational study demonstrates that second- rather than third-trimester maternal vaccination results in higher birth anti?pertussis toxin titers in preterm neonates.

  1. Factors influencing the abortion interval of second trimester pregnancy termination using misoprostol

    Directory of Open Access Journals (Sweden)

    Wan-Hua Ting

    2015-08-01

    Conclusion: Higher parity, intrauterine fetal demise, and preterm premature rupture of membranes were associated with shorter AI. The regimen of 200 μg oral misoprostol at 6-hour intervals following a 200 μg or 400 μg priming vaginal dose is feasible and efficacious for second trimester pregnancy termination.

  2. 78 FR 45896 - Fisheries of the Northeastern United States; Northeast Multispecies Fishery; Trimester Closure...

    Science.gov (United States)

    2013-07-30

    ... National Oceanic and Atmospheric Administration 50 CFR Part 648 RIN 0648-XC782 Fisheries of the Northeastern United States; Northeast Multispecies Fishery; Trimester Closure for the Common Pool Fishery AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric Administration (NOAA...

  3. Insulinoma in a third-trimester pregnant woman combined with pre-eclampsia

    DEFF Research Database (Denmark)

    Christiansen, Poul Erik; Vestergaard, Henrik

    2008-01-01

    Insulinomas are rare neuroendocrine tumors with an incidence of 4 per 1,000,000 person-years, being even rarer during pregnancy. During pregnancy most cases are recognized or become symptomatic during the first trimester. A 29-year-old woman, primigravida, was hospitalized in the 38th gestational...

  4. Influence of Behçet's disease on first and second trimester serum screening markers.

    Science.gov (United States)

    Yılmaz, Zehra Vural; Türkmen, Gülenay Gençosmanoğlu; Yılmaz, Elif; Dağlar, Korkut; Kırbaş, Ayşe; Sanhal, Cem; Yücel, Aykan; Uygur, Dilek

    2017-03-01

    Behçet's disease (BD) is a rare and multisystemic vasculitis disease. In this study, we investigated whether BD had any effect on the biochemical components of first and second trimester aneuploidy screening tests. A case-control retrospective study was conducted with 32 pregnant women with BD and 60 healthy pregnant women as controls. All pregnant womens' first trimester maternal serum pregnancy-associated plasma protein-A, free β-human chorionic gonadotropin and second trimester serum alpha-fetoprotein, unconjugated estriol and total human chorionic gonadotropin levels were examined from medical records. First and second serum screening markers were compared between pregnancies with BD and without. There was no difference in age, body mass index and obstetric history between the groups. No significant difference was observed between the groups in terms of first and second trimester serum screening test results in the absence of aneuploidy or neural tube defect. Gestational age at birth, birth weight and neonatal intensive care admission rate were also similar between the groups. Both first and second serum screening tests for Down syndrome may be recommended to pregnant women with BD without the need to readjust these markers. Pregnancy with BD was not associated with adverse perinatal outcome with respect to gestational age at birth or birth weight. © 2016 Japan Society of Obstetrics and Gynecology.

  5. The effect of inherited thrombophilia on second trimester combined aneuploidy screening test markers.

    Science.gov (United States)

    Cıkman, Muzaffer Seyhan; Seckin, Kerem Doga; Karslı, Mehmet Fatih; Baser, Eralp; Cıkman, Duygu Ilke; Cicek, Mahmut Nedim

    2015-04-01

    To determine whether inherited thrombophilia affects components of second trimester combined aneuploidy screening test. A case-control study was performed between 1 December 2010 and 1 February 2012, at a tertiary referral hospital. Singleton pregnancies with inherited thrombophilia that underwent second trimester (16-19(+6) week) combined aneuploidy screening test were included in the study. Maternal serum alfa fetoprotein, unconjugated estriol, human chorionic gonadotropin levels and multiple of median (MoM) levels were compared between the study group and controls. Within the study period, 18,943 women with singleton pregnancies had a combined second trimester aneuploidy screening test at our institution. Among these, 26 women met the criteria of thrombophilia. A control group that comprised 275 women with similar gestational age was generated, using a 1:1 ratio. Unconjugated estriol MoM levels were significantly lower in women with inherited thrombophilia (p = 0.02). But there was no statistically significant difference for unconjugated estriol levels, human chorionic gonadotropin, alfa fetoprotein and their MoM levels. Our study suggest that in patients with hereditary thrombophilia a new correction factor should be used, when calculating unconjugated estriol MoM value, which is one of the markers of second trimester aneuploidy screening test.

  6. Relationship between maternal thyroid hormones and the biochemical markers of the first trimester aneuploidy screening.

    Science.gov (United States)

    Aytan, Hakan; Caliskan, Ahmet C; Demirturk, Fazlı; Sahin, Semsettin; Erdogan, Filiz; Kuzu, Zehra

    2013-06-01

    The role of thyroid function in biochemical markers of first trimester screening has not been assessed. The aim of the present study was to investigate if there were any relation between maternal thyroid hormones and free-beta subunit of human chorionic gonadotropin (fβ-hCG) and pregnancy-associated plasma protein A (PAPP-A) levels as the biochemical markers of the combined first trimester aneuploidy screening. 375 pregnant women between 11 and 14 weeks of gestation who were offered routine first trimester prenatal aneuploidy screening and whose thyroid hormone levels (Thyroid stimulating hormone (TSH), free and total thyroxine, free and total triiodothyronine, anti thyroid peroxidase antibody) were measured were assessed. Correlation of free-β-hCG and PAPP-A with maternal thyroid hormones was analyzed. There was no statistically significant correlation between maternal TSH, free and total thyroxine, free and total triiodothyronine, anti-thyroid peroxidase antibodies and free-β-hCG and PAPP-A as biochemical markers of first trimester aneuploidy screening. Maternal thyroid function does not seem to affect secretion of fβ-hCG and PAPP-A.

  7. First trimester maternal serum alpha-fetoprotein is not raised in pregnancies with open spina bifida.

    Science.gov (United States)

    Spencer, Kevin; Khalil, Asma; Brown, Louise; Mills, Ian; Horne, Hannah

    2014-02-01

    Two recent studies have suggested that maternal serum alpha fetoprotein (AFP) levels are increased in the first trimester of pregnancies in which the fetus has an open spina bifida. This is contrary to previously published studies. This study assesses further whether maternal serum AFP is elevated in the first trimester in cases with open spina bifida. Cases with open spina bifida were identified from our fetal database, and corresponding first trimester screening samples were retrieved and analysed for maternal serum AFP. A control group was selected by taking three samples matched for gestational age (exact day), ethnicity and smoking status and received in the laboratory on the same day. AFP was measured with the Kryptor platform and free β-hCG and pregnancy-associated plasma protein A results were available from the fetal database. Thirty-nine open spina bifida cases were identified with a control group of 126 cases. The median multiple of the median AFP in the cases were not significantly different from the controls (0.92 vs 1.06 p = 0.3511) as was the case for free β-hCG (0.87 vs 0.95 p = 0.7146) and pregnancy-associated plasma protein A (1.04 vs 1.04 p = 0.261). Our results confirm that maternal serum biochemical markers in the first trimester are unable to distinguish cases in which the fetus has open spina bifida. © 2013 John Wiley & Sons, Ltd.

  8. Isolated polyhydramnios in the third trimester: is a gestational diabetes evaluation of value?

    Science.gov (United States)

    Frank Wolf, Maya; Peleg, David; Stahl-Rosenzweig, Talia; Kurzweil, Yaffa; Yogev, Yariv

    2017-11-01

    We evaluated implications of testing for gestational diabetes mellitus (GDM) in pregnancies complicated by third trimester isolated polyhydramnios with previous negative diabetes screening test. In this retrospective cohort study of 104 pregnant women with polyhydramnios between 2005 and 2013, all had normal first trimester fasting glucose and normal glucose challenge test (GCT polyhydramnios, one abnormal value in the oral glucose tolerance test (OGTT) was identified in four additional women (3.8%). No significant differences were found in risk factors for GDM, mean second trimester GCT (117.5 vs. 107.2 mg/dL, p = 0.38) or fasting glucose values (82 vs. 86 mg/dL, p = 0.29) between women in the polyhydramnios group with and without late GDM diagnosis. Moreover, no significant difference was found in relation to the mode of delivery or birth weight between the studied groups (3437 ± 611 vs. 3331 ± 515 g, p = 0.63). Diagnosis of third trimester polyhydramnios was not associated with increased risk for GDM or neonatal complications.

  9. Maternal first-trimester diet and childhood bone mass: The Generation R Study

    NARCIS (Netherlands)

    D.H.M. Heppe (Denise); M.C. Medina-Gomez (Carolina); A. Hofman (Albert); O.H. Franco (Oscar); F. Rivadeneira Ramirez (Fernando); V.W.V. Jaddoe (Vincent)

    2013-01-01

    textabstractBackground: Maternal diet during pregnancy has been suggested to influence bone health in later life. Objective: We assessed the association of maternal first-trimester dietary intake during pregnancy with childhood bone mass. Design: In a prospective cohort study in 2819 mothers and

  10. Cross-trimester repeated measures testing for Down's syndrome screening: an assessment.

    LENUS (Irish Health Repository)

    Wright, D

    2010-07-01

    To provide estimates and confidence intervals for the performance (detection and false-positive rates) of screening for Down\\'s syndrome using repeated measures of biochemical markers from first and second trimester maternal serum samples taken from the same woman.

  11. Second-trimester cervical length as risk indicator for Cesarean delivery in women with twin pregnancy

    NARCIS (Netherlands)

    Van de Mheen, L.; Schuit, E.; Liem, S. M. S.; Lim, A. C.; Bekedam, D. J.; Goossens, S. M. T. A.; Franssen, M. T. M.; Porath, M. M.; Oudijk, M. A.; Bloemenkamp, K. W. M.; Duvekot, J. J.; Woiski, M. D.; De Graaf, I.; Sikkema, J. M.; Scheepers, H. C. J.; Van Eijk, J.; De Groot, C. J. M.; Van Pampus, M. G.; Mol, B. W. J.

    2015-01-01

    Objective To determine whether second-trimester cervical length (CL) in women with a twin pregnancy is associated with the risk of emergency Cesarean section. Methods This was a secondary analysis of two randomized trials conducted in 57 hospitals in The Netherlands. We assessed the univariable

  12. Diagnosis of Apert syndrome in the second-trimester using 2D and 3D ultrasound

    NARCIS (Netherlands)

    David, A. L.; Turnbull, C.; Scott, R.; Freeman, J.; Bilardo, C. M.; van Maarle, M.; Chitty, L. S.

    2007-01-01

    To illustrate how Apert syndrome, a rare autosomal dominant genetic syndrome, can be detected in the second-trimester of pregnancy using 2D ultrasound, and how 3D ultrasound examination may provide parents with a better understanding of the structural defects affecting their baby. Fetal Medicine

  13. Effect of zircon-based tricolor pigments on the color, microstructure, flexural strength and translucency of a novel dental lithium disilicate glass-ceramic.

    Science.gov (United States)

    Yuan, Kun; Wang, Fu; Gao, Jing; Sun, Xiang; Deng, Zai-Xi; Wang, Hui; Jin, Lei; Chen, Ji-Hua

    2014-01-01

    The purpose of this study was to investigate the effect of zircon-based tricolor pigments (praseodymium zircon yellow, ferrum zircon red, and vanadium zircon blue) on the color, thermal property, crystalline phase composition, microstructure, flexural strength, and translucency of a novel dental lithium disilicate glass-ceramic. The pigments were added to the glass frit, milled, pressed, and sintered. Ninety monochrome samples were prepared and the colors were analyzed. The effect of the pigments on thermal property, crystalline phase composition, and microstructure were determined by differential scanning calorimetry (DSC), X-ray diffraction (XRD), and scanning electron microscopy (SEM), respectively. Addition of the pigments resulted in the acquisition of subtractive primary colors as well as tooth-like colors, and did not demonstrate significant effects on the thermal property, crystalline phase composition, microstructure, and flexural strength of the experimental glass-ceramic. Although significant differences (p zircon-based pigment colored ceramics, the translucencies of the latter were sufficient to fabricate dental restorations. These results indicate that the zircon-based tricolor pigments can be used with dental lithium disilicate glass-ceramic to produce abundant and predictable tooth-like colors without significant adverse effects, if mixed in the right proportions. Copyright © 2013 Wiley Periodicals, Inc.

  14. Detection of chromosomal abnormalities, congenital abnormalities and transfusion syndrome in twins

    DEFF Research Database (Denmark)

    Sperling, Lene; Kiil, C; Larsen, L U

    2007-01-01

    observational study were women with twin pregnancies diagnosed before 14 + 6 gestational weeks. The monochorionic pregnancies were scanned every second week until 23 weeks in order to rule out early TTTS. All pregnancies had an anomaly scan in week 19 and fetal echocardiography in week 21 that was performed...... by specialists in fetal echocardiography. Zygosity was determined by DNA analysis in all twin pairs with the same sex. RESULTS: Among the 495 pregnancies the prenatal detection rate for severe structural abnormalities including chromosomal aneuploidies was 83% by the combination of a first-trimester nuchal...... translucency scan and the anomaly scan in week 19. The incidence of severe structural abnormalities was 2.6% and two-thirds of these anomalies were cardiac. There was no significant difference between the incidence in monozygotic and dizygotic twins, nor between twins conceived naturally or those conceived...

  15. Limitations of Aneuploidy and Anomaly Detection in the Obese Patient

    Directory of Open Access Journals (Sweden)

    Paula Zozzaro-Smith

    2014-07-01

    Full Text Available Obesity is a worldwide epidemic and can have a profound effect on pregnancy risks. Obese patients tend to be older and are at increased risk for structural fetal anomalies and aneuploidy, making screening options critically important for these women. Failure rates for first-trimester nuchal translucency (NT screening increase with obesity, while the ability to detect soft-markers declines, limiting ultrasound-based screening options. Obesity also decreases the chances of completing the anatomy survey and increases the residual risk of undetected anomalies. Additionally, non-invasive prenatal testing (NIPT is less likely to provide an informative result in obese patients. Understanding the limitations and diagnostic accuracy of aneuploidy and anomaly screening in obese patients can help guide clinicians in counseling patients on the screening options.

  16. Prenatal Sonographic Features of Fetuses in Trisomy 13 Pregnancies (IV

    Directory of Open Access Journals (Sweden)

    Chih-Ping Chen

    2010-03-01

    Full Text Available Prenatal ultrasound is a powerful tool to detect structural abnormalities associated with the fetuses in trisomy 13 pregnancies. This article provides a comprehensive review of the prenatal sonographic markers of trisomy 13 in the first trimester, including fetal nuchal translucency thickness, fetal heart rate, fetal nasal bone, fetal tricuspid regurgitation, ductus venous flow, fetal crown-rump length, fetal trunk and head volume, fetal frontomaxillary facial angle, gestational sac volume and umbilical cord diameter, along with biochemical markers such as maternal serum free β-human chorionic gonadotropin, maternal serum pregnancy-associated plasma protein-A, maternal serum placental growth factor, and the fetal and total cell-free DNA concentration in the maternal circulation.

  17. Is the third trimester repeat ultrasound scan for placental localisation needed if the placenta is low lying but clear of the os at the mid-trimester morphology scan?

    Science.gov (United States)

    Kapoor, Shveta; Thomas, Joseph T; Petersen, Scott G; Gardener, Glenn J

    2014-10-01

    It is unclear whether women with a low-lying placenta (not overlapping the internal cervical os) at the mid-trimester scan need follow-up. The aim of the study was to determine the rate of placenta praevia, vasa praevia and cord prolapse in the third trimester in this cohort of women. A retrospective cohort study of women with a documented low-lying placenta (os) at the mid-trimester morphology ultrasound scan was done. A composite outcome of rate of placenta praevia, vasa praevia or cord prolapse at term was evaluated. Multivariate analysis was performed to investigate the variables influencing the composite outcome. In addition, a meta-analysis of methodologically similar studies was performed to investigate the effect of the placenta to os distance at the mid-trimester scan on the rate of placenta praevia at term. One hundred and eighty-one women with a low-lying placenta not overlapping the os at mid-trimester scan were identified. The composite outcome was documented in 20 (11.0%) women, including placenta praevia in 15 (8.3%). Based on multivariate analysis, multiparity, distance from os os distance at mid-trimester. Our study supports the recommendation to follow up all women with a placenta lying os at mid-trimester. © 2014 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  18. Effect of oxygen on multidrug resistance in the first trimester human placenta.

    Science.gov (United States)

    Lye, P; Bloise, E; Dunk, C; Javam, M; Gibb, W; Lye, S J; Matthews, S G

    2013-09-01

    The multidrug resistance proteins, P-glycoprotein (P-gp, encoded by the ABCB1 gene) and breast cancer resistance protein (BCRP, encoded by ABCG2) are highly expressed in the first trimester placenta. These transporters protect the fetus from exposure to maternally derived toxins and xenobiotics. Since oxygen is a regulator of multidrug resistance in various tissues, we hypothesized that changes in oxygen tension alter placental ABCB1/P-gp and ABCG2/BCRP expression in the first trimester. Placental specimens were collected from first (n = 7), second (n = 5) and term pregnancies (n = 5). First trimester placental villous explants were incubated (24 or 48 h) in different oxygen tension (3-20%). ABCB1, ABCG2 and VEGFA mRNA expression levels were assessed by RT-PCR and protein was localized by IHC. ABCB1 is expressed most highly in the first trimester placenta (p < 0.05), whereas ABCG2 expression does not change significantly over pregnancy. P-gp and BCRP staining is present in the syncytiotrophoblast and in cytotrophoblasts. ABCG2 mRNA is increased in hyperoxic (20%) conditions after 48 h (p < 0.05). In contrast, hypoxia (3%) did not change ABCB1 mRNA expression but significantly increased VEGFA mRNA (p < 0.05). Hypoxia resulted in increased BCRP staining in cytotrophoblasts and in the microvillous membrane of the syncytium. Whereas, hypoxia resulted in increased P-gp staining in proliferating cytotrophoblasts. We conclude that placental multidrug resistance expression, specifically ABCG2, is regulated by oxygen tension in the first trimester. It is possible that changes in placental oxygen supply are capable of altering fetal drug exposure especially during early pregnancy. Copyright © 2013 Elsevier Ltd. All rights reserved.

  19. Psychological impact of first-trimester prevention for preeclampsia on anxiety.

    Science.gov (United States)

    Simeone, Serena; Lojo, Cristina; Garcia-Esteve, Lluïsa; Triunfo, Stefania; Crovetto, Francesca; Arranz, Angela; Gratacós, Eduard; Figueras, Francesc

    2015-01-01

    This study aims to examine whether a first-trimester strategy of secondary prevention for preeclampsia increases anxiety in pregnant women. The anxiety levels of a cohort of women screened for preeclampsia at first trimester were measured by the Spielberg State-Trait Anxiety Inventory (STAI-S) and compared between women screened as low and high risk. In a subgroup of women, the anxiety levels were additionally measured at second and third trimester. A General Linear Model (GLM) for repeated measurements was performed to adjust for potential confounders (age, nulliparity and socio-economic level). A total of 255 women (135 low-risk and 120 high-risk) were evaluated. No differences were found in the mean STAI-S scores between low-risk and high-risk women: 35 (SD 9.9) and 34.6 (SD 10.1); p = 0.77. The proportion of women with high anxiety was not significantly different between groups (28/134 [20.7%] vs 24/120 [20%]; p = 0.88). No differences were found in the subgroups (51 low-risk and 50 high-risk) in which the anxiety levels were also measured at second and third trimester: 35.8 (SD 8.8) vs 35.2 (SD 9.7), p = 0.74, and 37.2 (SD 9.4) vs 35.3 (SD 8.6), p = 0.3. These differences remained non-significant after adjustment for potential confounders. A strategy of first-trimester screening for preeclampsia does not increase maternal anxiety. © 2014 John Wiley & Sons, Ltd.

  20. Maternal first-trimester dietary intake and childhood blood pressure: the Generation R Study.

    Science.gov (United States)

    van den Hil, Leontine C L; Rob Taal, H; de Jonge, Layla L; Heppe, Denise H M; Steegers, Eric A P; Hofman, Albert; van der Heijden, Albert J; Jaddoe, Vincent W V

    2013-10-01

    Suboptimal maternal dietary intake during pregnancy might lead to fetal cardiovascular adaptations and higher blood pressure in the offspring. The aim of the present study was to investigate the associations of maternal first-trimester dietary intake with blood pressure in children at the age of 6 years. We assessed first-trimester maternal daily dietary intake by a FFQ and measured folate, homocysteine and vitamin B₁₂ concentrations in the blood, in a population-based prospective cohort study among 2863 mothers and children. Childhood systolic and diastolic blood pressure was measured using a validated automatic sphygmomanometer. First-trimester maternal daily intake of energy, fat, protein and carbohydrate was not associated with childhood blood pressure. Furthermore, maternal intake of micronutrients was not associated with childhood blood pressure. Also, higher maternal vitamin B₁₂ concentrations were associated with a higher diastolic blood pressure (0·31 mmHg per standard deviation increase in vitamin B₁₂ (95% CI 0·06, 0·56)). After taking into account multiple testing, none of the associations was statistically significant. Maternal first-trimester folate and homocysteine concentrations were not associated with childhood blood pressure. The results from the present study suggest that maternal Fe intake and vitamin B₁₂ concentrations during the first trimester of pregnancy might affect childhood blood pressure, although the effect estimates were small and were not significant after correction for multiple testing. Further studies are needed to replicate these findings, to elucidate the underlying mechanisms and to assess whether these differences in blood pressure persist in later life.

  1. Correction of first trimester biochemical aneuploidy screening markers for smoking status: influence of gestational age, maternal ethnicity and cigarette dosage.

    Science.gov (United States)

    Spencer, Kevin; Cowans, Nicholas J

    2013-02-01

    To examine the gestational age, maternal ethnicity and cigarette dosage effects of the reduction of maternal serum pregnancy-associated plasma protein A (PAPP-A) and free-β human chorionic gonadotrophin (free hCGβ) in smokers. Maternal serum PAPP-A and free hCGβ corrected for confounders, excluding smoking, in first trimester smokers and nonsmokers were compared by gestational age, maternal ethnicity and cigarette dosage. A small set of second trimester smokers and nonsmoker controls were analysed for PAPP-A along with free hCGβ and assessed for gestational age effects of smoking. Pregnancy-associated plasma protein A reduction by smoking in the first trimester was not influenced by gestational age, however free hCGβ levels were only significantly reduced in weeks 12 and 13 in smokers. Ethnicity and cigarette dosage were also found to influence the reduction of both makers in smokers in the first trimester. In second trimester smokers, PAPP-A was found to be reduced by less and free hCGβ reduced by more than in the first trimester, although no second trimester gestational age effect on smoking was found. Current methods of correcting for smoking status may be an oversimplification of a more complex subject. © 2012 John Wiley & Sons, Ltd.

  2. Trimester-specific reference interval for thyroid hormones during pregnancy at a Tertiary Care Hospital in Haryana, India.

    Science.gov (United States)

    Rajput, Rajesh; Singh, Bhagat; Goel, Vasudha; Verma, Amit; Seth, Shashi; Nanda, Smiti

    2016-01-01

    Reference intervals for thyroid hormone during pregnancy need to be gestational age, method, and population specific and there is need to establish trimester-specific thyroid levels for the different population across the world. The aim of this study was to establish trimester-specific reference range for thyroid hormone during pregnancy in a tertiary care center in Haryana. A total of 1430 pregnant women were recruited for the study. Participants having any history of chronic illness, goiter on physical examination, thyroid illness in the past or present, consuming thyroid medications, family history of thyroid illness, presence of anti-thyroid peroxidase antibody, poor obstetrics history were excluded from the study and reference population was identified to calculate serum free triiodothyronine (FT3), free thyroxine (FT4) and thyrotropin (TSH) for each trimester of pregnancy. The 2.5-97.5 th percentiles for FT3, FT4, and TSH obtained in this study were 2.53-4.54 pg/ml, 0.88-1.78 ng/ml and 0.37-3.69 μIU/ml in the first trimester, 2.0-4.73 pg/ml, 0.91-1.78 ng/ml and 0.54-4.47 μIU/ml in the second trimester, 2.01-4.01 pg/ml, 0.83-1.73 ng/ml, and 0.70-4.64 μIU/ml in the third trimester of pregnancy. Mean TSH increased and mean FT3 decreased significantly with the progression of gestational period. FT4 decreased from trimester 1-3 rd , but the decrease was nonsignificant from 2 nd to 3 rd trimester. Existing results for trimester-specific reference intervals for thyroid hormones are inconsistent and cannot be extrapolated due to differences in ethnicity, maternal iodine status, laboratory assay method, and rigor for selection of reference population. Thus, establishment of reference intervals in each region is of great importance.

  3. Placenta Increta after First-Trimester Dilatation and Curettage Manifesting as an Unusual Uterine Mass: Magnetic Resonance Findings

    Energy Technology Data Exchange (ETDEWEB)

    Ju, W.; Kim, S.C. [Dept. of Obstetrics and Gynecology, and Medical Research Inst., School of Medicine, Ewha Womens Univ., Seoul (Korea)

    2007-10-15

    Placenta increta during the first trimester of pregnancy is extremely rare. Only a few cases of placenta accreta during the latter half of pregnancy manifesting as a uterine mass have been published. This report describes a case of placenta increta that caused prolonged bleeding after a first-trimester abortion, and was identified by magnetic resonance imaging (MRI) as a heterogeneous mass in the myometrium. This is the first report of a placenta increta detected as a uterine mass after first-trimester dilatation and curettage, and its MRI findings.

  4. The maternal age-related first trimester risks for trisomy 21, 18 and 13 based on Danish first trimester data from 2005 to 2014

    DEFF Research Database (Denmark)

    Hartwig, Tanja Schlaikjær; Sørensen, Steen; Jørgensen, Finn Stener

    2016-01-01

    OBJECTIVES: Most currently used age-related risks of T21, T18 and T13 are based on estimates of the live-birth prevalence, and describe an exponential increase of risk by increased maternal age. We investigated the first trimester prevalence of T21, T18 and T13 in a large population of Danish women....... METHODS: From the Danish Cytogenetic Central Registry we got the information of all pre- and postnatally diagnosed fetuses with T21, T18 or T13 between 2005 and 2014 in Denmark. Information on the total number of births and maternal age at birth were gathered from StatBank Denmark. RESULTS: The total...... number of included women was 605 853. The total number of T21 cases was 1564, T18 cases was 401 and T13 cases was 157. The overall first trimester prevalence per 10 000 pregnancies was 25.8 for T21, 6.6 for T18 and 2.6 for T13. Boltzmann sigmoidal model (Y = Bottom + (top-bottom / (1 - exp (V50 - X...

  5. A molar masquerading as an ectopic pregnancy in the early first trimester: a salutary lesson

    Directory of Open Access Journals (Sweden)

    Govind A

    2012-08-01

    Full Text Available Abha Govind,1 Nisha Lakhi21Department of Obstetrics and Gynaecology, North Middlesex University Hospital, London, UK; 2Department of Obstetrics and Gynecology, Richmond University Medical Center, Staten Island, New York, NY, USAAbstract: The authors report a case in which a molar pregnancy was mistaken for an ectopic pregnancy in the early first trimester. This confusion delayed diagnosis and caused distress; follow-up led to the final diagnosis of complete hydatidiform mole. Correct preoperative diagnosis of molar pregnancy by ultrasound in early pregnancy may be tricky. It is important to obtain histological evidence to make the final diagnosis of gestational trophoblastic disease. While relatively rare, consideration of molar pregnancy in the differential diagnosis of early pregnancy loss may avoid unnecessary distress.Keywords: first trimester ultrasound, molar pregnancy, gestational trophoblastic disease, complete hydatidiform mole, diagnosis

  6. A Rare Case of Second Trimester Uterine Rupture in Unscarred Uterus

    Directory of Open Access Journals (Sweden)

    Poonam Kashyap

    2017-11-01

    Full Text Available Second trimester uterine rupture is rare and presents with life threatening emergency. Few cases have been reported in literature. Most of the cases which have been reported are with the use of labor-induction agents in late termination of pregnancy. Others are involving any surgical procedures in placenta percreta or scarred uterus. The main contributory factors were scarred uterus and abnormal placentation. In this study, uterine rupture had occurred in unscarred uterus in non-laboring women in second trimester without any intervention which is very rare to found. The lack of index of high suspicion diverts attention to search for other non-gynecological causes. Our aim is to create awareness through this case study to avoid delay in diagnosis and timely management of such cases.

  7. Inadvertent 131I therapy for hyperthyroidism in the first trimester of pregnancy

    International Nuclear Information System (INIS)

    Stoffer, S.S.; Hamburger, J.I.

    1976-01-01

    Of 963 physicians surveyed to determine therapeutic attitudes toward, and experience with inadvertent radioiodine therapy for hyperthyroidism during the first trimester of pregnancy, 116 physicians (of 517 responding) reported 237 cases. Therapeutic abortion was advised for 55 patients by 22 physicans. From the 182 remaining pregnancies there were two spontaneous abortions, two stillborn, one neonate with biliary atresia, and one with respiratory distress. This complication rate was not greater than might be expected in a similar number of random pregnancies. On the other hand, six infants were hypothyroid (transient for one) and four of these were mentally deficient. Three mothers of hypothyroid infants had received radioiodine therapy in the second trimester. None of the six mothers of hypothyroid infants had had pregnancy tests prior to radioiodine therapy. Survey responses indicate that routine pregnancy testing prior to radioiodine therapy for patients in the child-bearing age is not yet a standard procedure. It should be

  8. Amniotic fluid gamma-glutamyl transpeptidase activity during the second trimester.

    Science.gov (United States)

    Legge, M; Potter, H C

    1986-03-12

    Gamma glutamyl transpeptidase (GGTP) activity was determined in second trimester amniotic fluid taken from normal fetuses and those with fetal abnormalities. GGTP activity decreased with advancing gestation. Increasing meconium contamination correlated with an increase in GGTP activity as did increasing fetal blood contamination. Maternal blood did not affect GGTP activity. Anencephaly did not significantly alter the GGTP activity, however, fetuses with spina bifida had significantly lower activity. Klinefelters and Turners syndromes both had GGTP activity close to the 50th percentile, and two trisomy 21 fetuses had GGTP activity below the 40th percentile. Two trisomy 18 fetuses and two translocation Downs syndromes (46 XY, t (14;21) had GGTP activities considerably lower than the 20th percentile as did a fetus with gastroschisis. Second trimester amniotic fluid GGTP activity may provide an easy preliminary test to screen amniotic fluids for the possibility of certain fetal chromosome abnormalities.

  9. Location of the appendix at the third trimester of pregnancy: A new approach to old dilemma.

    Science.gov (United States)

    Erkek, A; Anik Ilhan, G; Yildizhan, B; Aktan, A O

    2015-01-01

    The aim of this study was to determine the location of the appendix at the third trimester of pregnancy as there are conflicting results in literature. Distances from the base of the appendix were measured intra-operatively to the anterior iliac spine (A), symphysis pubis (B) and the xyphoid process (C). The same measurements were taken from McBurney's point on the abdominal wall (A1, B1 and C1). In the allocated 21 pregnant and 18 non-pregnant women, distance A and B were 10.3 ± 0.9 cm and 18.3 ± 3.2 cm in pregnant and 6.7 ± 0.9 cm and 13.2 ± 0.9 cm in non-pregnant women (p pregnancy. Therefore, McBurney's point cannot be used as a reference point to localise the appendix at the third trimester of pregnancy.

  10. Comparison of gemeprost and vaginal misoprostol in first trimester mifepristone-induced abortion

    DEFF Research Database (Denmark)

    Svendsen, Pernille Fog; Rørbye, Christina; Vejborg, Thomas

    2005-01-01

    Abstract Background The aim of this study was to compare efficacy and side effects of gemeprost and vaginal misoprostol in mifepristone-induced abortions in women up to 63 days of gestation. Methods A retrospective study of 833 consecutive patients admitted for medical termination of first...... trimester pregnancy was conducted. Four-hundred ten patients received mifepristone 600 mg, followed 48 h later by gemeprost 1 mg (regimen I), and 423 patients received mifepristone 200 mg followed by vaginal misoprostol 800 µg (regimen II). Success rates were evaluated after 2 weeks and after 3 months......, gemeprost and vaginal misoprostol are equally effective for termination of first trimester abortion, but may be associated with varying intensity of side effects....

  11. An Unusual Case of Fulminant Type 1 Diabetes during the Second Trimester of Pregnancy

    Directory of Open Access Journals (Sweden)

    Tomohiro Okuda

    2014-01-01

    Full Text Available Fulminant type 1 diabetes is a new subtype of rapid-onset type 1 diabetes, with pancreatic exocrine dysfunction, that usually develops during the third trimester of pregnancy. We describe a patient with fulminant type 1 diabetes onset during her second trimester, resulting in premature delivery. The 34-year-old woman, without any known risk factors for diabetes mellitus, experienced a sudden stillbirth at 24-weeks gestation. Her blood glucose level was 950 mg/dL and she was positive for urine ketone bodies. The condition met all the diagnostic criteria for fulminant type 1 diabetes, and was diagnosed as such. Although this disease is rare, its progression is rapid, and its clinical course is severe and occasionally leads to death; therefore, a full knowledge of the disease is important to facilitate an accurate diagnosis.

  12. Using knowledge management to improve learning experience of first-trimester students

    Directory of Open Access Journals (Sweden)

    Nelson K. Y. Leung

    2015-06-01

    Full Text Available To address the lack of insights into the engagement of tertiary students to manage knowledge at a course level, a knowledge management approach is proposed to allow students to interact with lecturers inside and outside a large lecture hall to create, disseminate, use and evaluate knowledge. The proposed approach was applied to an undergraduate business computing related course conducted at the offshore campus of an Australian university in the third trimester of 2012. The proposed KM approach was evaluated using quantitative analysis. The findings show that the majority of the students agreed that the computerized tool (Facebook could enhance their learning experience by allowing students to ask for, share, discuss, and extend knowledge. In particular, the KM approach provided additional channels and platforms for the first-trimester students who were passive and preferred not to seek help from lecturers directly for cultural reasons.

  13. Multiple anomalies in a fetus exposed to low-dose methotrexate in the first trimester.

    Science.gov (United States)

    Nguyen, Christine; Duhl, Adam J; Escallon, Cathleen S; Blakemore, Karin J

    2002-04-01

    Methotrexate has multiple therapeutic uses in women of reproductive age including treatment for ectopic pregnancy, neoplastic disease, autoimmune disorders, and inflammatory conditions. More frequent use of methotrexate may result in an increased number of exposures in pregnant women and their fetuses. A 16-year-old gravida 1, para 0 used oral methotrexate treatment of 7.5 mg per day for psoriasis for 2 days at 3.5 weeks postconception. Multiple anomalies were noted on an 18-week ultrasound. Fetopsy revealed craniofacial, axial skeletal, cardiopulmonary, and gastrointestinal abnormalities. A minimal, low-dose, brief exposure to methotrexate in the first trimester resulted in a fetus with multiple internal and external malformations. Some of the anomalies (craniofacial and skeletal) have been previously reported with first- trimester methotrexate exposure. This case depicts the association of cardiopulmonary and gastrointestinal abnormalities with methotrexate exposure.

  14. The effect of placenta previa on blood loss in second-trimester pregnancy termination.

    Science.gov (United States)

    Thomas, A G; Alvarez, M; Friedman, F; Brodman, M L; Kim, J; Lockwood, C

    1994-07-01

    To determine whether placenta previa increases bleeding during second-trimester pregnancy termination. The records of 131 consecutive women undergoing elective pregnancy termination at 13-24 weeks' gestation were reviewed and divided into those with and without placenta previa based on an ultrasound examination before the procedure. These two groups were then compared for differences in maternal characteristics, estimated blood loss, operative time, infection, and hospital admission. Twenty-three of 131 women (17.6%) had placenta previa. Sixty-seven percent of the previa patients smoked, versus 37% in the control group, a statistically significant difference. A statistical difference was noted with respect to placenta previa in intraoperative blood loss (P < .05), but not operative time, time to discharge, infection, hemorrhage, or other complications. Second-trimester pregnancy terminations in the presence of placenta previa are associated with a higher estimated blood loss, but no apparent increase in abortion-related infection, postoperative transfusion requirements, hysterectomy, or other complications.

  15. First trimester serum levels of the soluble transcobalamin receptor, holo-transcobalamin, and total transcobalamin in relation to preeclampsia risk

    DEFF Research Database (Denmark)

    Abuyaman, Omar; Torring, Niels; Obeid, Rima

    2016-01-01

    transcobalamin (TC) with the risk of subsequent preeclampsia using serum samples from asymptomatic first trimester pregnant women. Moreover, we aimed to establish reference intervals of the aforementioned biomarkers for first trimester pregnant women who remained healthy throughout pregnancy. STUDY DESIGN...... preeclampsia while the controls remained normotensive throughout pregnancy. We measured the serum concentration of sCD320, holoTC, and total TC by using in-house ELISA methods. RESULTS: First trimester median concentrations of sCD320, holoTC and total TC were not significantly different between cases...... and controls. The odd ratio for developing preeclampsia based on exposure to low or high levels of sCD320, holoTC or total TC at first trimester was not significant. The reference intervals (2.5-97.5% percentiles (median)) derived from the controls were 50-170 (90) pmol\\L for sCD320, 20-140 (70) pmol...

  16. Fetal gender determination through Y-STR analysis of maternal plasma during the third trimester of pregnancy

    Directory of Open Access Journals (Sweden)

    Hanaa M.H. Aal-Hamdan

    2015-01-01

    Conclusion: It is recommended to use Y-STR profiling as an alternative technique for fetal gender determination during the third trimester of pregnancy, in addition to its significance in forensic casework.

  17. First-trimester maternal ophthalmic artery Doppler analysis for prediction of pre-eclampsia.

    Science.gov (United States)

    Gurgel Alves, J A; Praciano de Sousa, P C; Bezerra Maia E Holanda Moura, S; Kane, S C; da Silva Costa, F

    2014-10-01

    To determine the performance of a multiparametric test comprising maternal risk factors, uterine artery Doppler and ophthalmic artery Doppler in the first trimester of pregnancy for the prediction of pre-eclampsia (PE). This prospective observational cohort study recruited patients in the first trimester of pregnancy. Maternal uterine artery and ophthalmic artery Doppler assessments were performed in 440 singleton pregnancies at 11-14 weeks of gestation. Additional history was obtained through participant questionnaires, and follow-up occurred to discharge postdelivery. The normotensive and pre-eclamptic groups were compared using parametric (Student's t-test) and non-parametric (Mann-Whitney U-test) tests. Univariable and multivariable logistic regression analyses were performed to determine which biophysical factors, and which of the factors among the maternal characteristics and medical and obstetric history, had a significant contribution to the prediction of PE in a multiparametric model. Thirty-one (7%) patients developed PE, including nine (2%) who required delivery before 34 weeks (early PE) and 22 (5%) with late PE. There were statistically significant differences in uterine artery pulsatility index (UtA-PI) and ophthalmic artery first diastolic peak (PD1) mean values between the PE and control groups. In a multiparametric model, both UtA-PI and PD1 achieved a 67% detection rate for early PE, although when combined, the detection rate only increased to 68%. The efficiency of ophthalmic artery PD1 in the first trimester as a predictive marker for the later development of PE was approximately equal to that described for uterine artery Doppler. Although these findings do not support the replacement of uterine artery Doppler analysis in multiparametric predictive models for PE, they do provide novel insights into first-trimester maternal systemic vascular changes that precede the clinical development of this condition. Copyright © 2014 ISUOG. Published by

  18. Association of first-trimester angiogenic factors with placental histological findings in late-onset preeclampsia.

    Science.gov (United States)

    Triunfo, Stefania; Crovetto, Francesca; Crispi, Fatima; Rodriguez-Sureda, Victor; Dominguez, Carmen; Nadal, Alfons; Peguero, Anna; Gratacos, Eduard; Figueras, Francesc

    2016-06-01

    To explore in women with late-onset preeclampsia (PE) the association between maternal levels of angiogenic/antiangiogenic factors in the first trimester of pregnancy and histological findings attributable to placental underperfusion (PUP). A nested case-control cohort study was conducted in 73 women with pregnancies complicated by late-onset PE (>34 weeks at delivery) matched with controls. First trimester uterine artery Doppler (UtA); maternal levels of placental growth factor (PlGF) and soluble fms-like tyrosine kinase-1 (sFlt-1) were retrieved. Placentas were histologically evaluated using a hierarchical and standardized classification system. One-way ANOVA with linear polynomial contrast or linear-by-linear association test was performed to test the hypothesis of a linear association across study groups (controls, PE without PUP and PE with PUP). In 54 (74%) placentas, 89 placental histological findings qualifying for PUP were found. Across study groups, significant values were observed in maternal levels of decreased PlGF (MoM values: 1.53, 1.41 and 1.37; p UtA Doppler (MoM values: 1, 1.26 and 1.32; p < 0.001), and worse perinatal outcomes in terms of gestational age at delivery, cesarean section for not reassuring fetal status, birth weight and neonatal acidosis. In late-onset PE an imbalance of circulating angiogenic and anti-angiogenic factors already present at 8-10 weeks of pregnancy was associated with histological findings reflecting placental insufficiency. An early first trimester screening by angiogenic factors might help to identify patients with placental involvement among late-onset PE cases. In late-onset preeclampsia, first-trimester uterine Doppler and circulating levels of angiogenic/antiangiogenic factors are associated with placental underperfusion. Copyright © 2016 Elsevier Ltd. All rights reserved.

  19. [Combined first trimester screening and cell-free fetal DNA - “next generation screening”].

    Science.gov (United States)

    Kagan, K O; Eiben, B; Kozlowski, P

    2014-06-01

    In the last decades, prenatal screening for aneuploidy has become increasingly effective. While first trimester combined screening is considered to be the current gold standard, the use of cell-free fetal DNA (cffDNA), which is also called noninvasive prenatal testing (NIPT), will result in a change of paradigm. Respective studies indicate that in screening for trisomy 21, the detection and false-positive rates are 99 % and 0.1 %, respectively. For trisomies 18 and 13, there is less evidence but recent studies report detection rates of 98 % and 86 %. Despite the excellent results in screening for trisomy 21, NIPT should not be considered as a diagnostic test. Due to the costs of NIPT, it is unlikely that NIPT will be applied in the near future in population-based screening for trisomy. In addition, the scope of the current approach in first trimester screening exceeds the screening for aneuploidy as it is possible to assess the risk for various pregnancy complications. Therefore, a combination of both NIPT and first trimester combined screening seems reasonable. Both examinations could be applied in a contingent model where the latter is offered to everyone and NIPT is restricted to women with an intermediate risk after first trimester combined screening. Such a policy would result in a detection rate of about 97 % for a false-positive rate of about 1 %. While NIPT currently focuses on screening for trisomy 21, 18, 13 and sex chromosomal abnormalities, the scope of NIPT will soon become broader. In this respect, some study groups have managed to examine the whole fetal genome within the course of the pregnancy. However, moral and ethical considerations need to be taken into account. © Georg Thieme Verlag KG Stuttgart · New York.

  20. Intra-abdominal pressure in third trimester pregnancy complicated by acute pancreatitis: an observational study.

    Science.gov (United States)

    Sun, Liqun; Li, Weiqin; Sun, Fuxi; Geng, Yanxia; Tong, Zhihui; Li, Jieshou

    2015-09-22

    It is known that intra-abdominal hypertension has high morbidity in acute pancreatitis and has detrimental effects on patients. For third trimester pregnancy complicated by acute pancreatitis, the intra-abdominal pressure may have its own characteristic. This article will discuss this clinical scenario. This observational study in a cohort group was performed in the surgical intensive care unit of a tertiary hospital. Medical records were reviewed from each acute pancreatitis exactly in third trimester pregnancy. The main statistical methods were Mann-Whitney U test and bivariate Pearson correlation analysis. During the study interval, there were totally 17 pregnancies complicated by acute pancreatitis in the third trimester. All cases with moderate or severe acute pancreatitis had intra-abdominal hypertension of mean value of 16.7 mm Hg (range, 12.9-22.0 mm Hg). The intra-abdominal pressure had significant correlation with APACHE II score (r = 0.7456, p = 0.0006), while a negative correlation was showed with the umbilical artery pH value and with 1-min Apgar score (r = -0.8232, p = 0.0005; r = -0.7465, p = 0.0034; respectively). The intra-abdominal pressure of those with live infants was lower than that of those with dead ones (13.78 ± 2.554 vs. 19.84 ± 1.695, p = 0.0019). The incidence of intra-abdominal hypertension seems higher in moderate or severe acute pancreatitis in third trimester pregnancy than the non-pregnant cases but there's no significance in this study. Acute elevated intra-abdominal pressure accounts for great association with mother's serious scenario and fetal mortality.

  1. One or two day mifepristone-misoprostol interval for second trimester abortion

    DEFF Research Database (Denmark)

    Nilas, Lisbeth; Glavind-Kristensen, Marianne; Vejborg, Thomas

    2007-01-01

    METHODS: A retrospective 2-year cohort study of 127 women, with gestation between 13 and 24 weeks and a live fetus, seeking induced abortion. The aim was to compare the effect of a 1-day and a 2-day interval between oral mifepristone (200 mg) and vaginal misoprostol (400 microg) every 3 h. RESULTS...... with lower gestation (10.2 versus 6.8 h; pmisoprostol is effective in the second trimester, and the interval between the drugs can be reduced allowing individualised...

  2. Comparison of Sublingual and Vaginal Misoprostol for Second-Trimester Pregnancy Terminations

    OpenAIRE

    Milani, Forozan; Sharami, Seyede Hajar; Arjmandi, Saeedeh

    2014-01-01

    Objective Comparing sublingual and vaginal misoprostol in second trimester pregnancy termination. Materials and methods In this study 268 women at 12-24 weeks of gestation candidate for pregnancy termination were enrolled. Women were randomly divided in two groups. The first group received 400 µg sublingual misoprostol and vaginal placebo and the second group received 400 µg vaginal misoprostol and sublingual placebo every 4 hours for a maximum of five doses. The course of misoprostol was rep...

  3. Different Time Schedules of Mifepristone and Misoprostol in Second Trimester Medical Abortion: A Comparative Study

    Directory of Open Access Journals (Sweden)

    Nalini Sharma

    2017-07-01

    Full Text Available Background & aim: Recently, the use of mifepristone followed by misoprostol after 36-48 h has been demonstrated to be an effective and safe method for the second trimester medical abortion. However, this regimen entails long total abortion time, and consequently increases the financial burden and anxiety in the patients. We hypothesize that one day interval would be also effective and can be used to provide the abortion care. Regarding this, the present study aimed to compare the effectiveness and safety of 24- and 36-hour intervals between the administration of mifepristone and misoprstol for second trimester abortion. Methods: This prospective comparative study was conducted on 70 females who opted for second trimester medical abortion between 12-20 weeks. Mifepristone (200 mg was followed by sublingual misoprostol (800 mcg after one and two days in the first and second groups, respectively. Four hours after the administration of 800 mcg misoprostol, all patients received 400 mcg sublingual misoprostol every 4 h (maximum of four doses in 24 h. For the purpose of the study, such parameters as the rate of successful abortion 24 h after the first dose of misoprostol, abortion duration, and the associated side effect profile were examined. Results: According to the results of the present study, the two-day interval (100% was more effective than the one-day interval (91.4% (P=0.021. Furthermore, the mean induction abortion duration was significantly less in the two-day regimen. However, the side effect profiles were comparable in both groups. Conclusion: As the findings of the present study indicated, both schedules of mifepristone and misoprostol were safe and effective in second trimester abortion. The 36-hour interval between mifepristone and misoprostol was more effective than the 24-hour interval. Furthermore, it had shorter abortion duration. We can individualize the patient care by offering a one-day interval regimen since it is more

  4. Adjuvant breast cancer chemotherapy during late-trimester pregnancy: not quite a standard of care

    Directory of Open Access Journals (Sweden)

    Epstein Richard J

    2007-05-01

    Full Text Available Abstract Background Diagnosis of breast cancer during pregnancy was formerly considered an indication for abortion. The pendulum has since swung to the other extreme, with most reviews now rejecting termination while endorsing immediate anthracycline-based therapy for any pregnant patient beyond the first trimester. To assess the evidence for this radical change in thinking, a review of relevant studies in the fields of breast cancer chemotherapy, pregnancy, and drug safety was conducted. Discussion Accumulating evidence for the short-term safety of anthracycline-based chemotherapy during late-trimester pregnancy represents a clear advance over the traditional norm of therapeutic abortion. Nonetheless, the emerging orthodoxy favoring routine chemotherapy during gestation should continue to be questioned on several grounds: (1 the assumed difference in maternal survival accruing from chemotherapy administered earlier – i.e., during pregnancy, rather than after delivery – has not been quantified; (2 the added survival benefit of adjuvant cytotoxic therapy prescribed within the hormone-rich milieu of pregnancy remains presumptive, particularly for ER-positive disease; (3 the maternal survival benefit associated with modified adjuvant regimens (e.g., weekly schedules, omission of taxanes, etc. has not been proven equivalent to standard (e.g., post-delivery regimens; and (4 the long-term transplacental and transgenerational hazards of late-trimester chemotherapy are unknown. Summary Although an incrementally increased risk of cancer-specific mortality is impossible to exclude, mothers who place a high priority on the lifelong well-being of their progeny may be informed that deferring optimal chemotherapy until after delivery is still an option to consider, especially in ER-positive, node-negative and/or last-trimester disease.

  5. Maternal first-trimester diet and childhood bone mass: the Generation R Study.

    Science.gov (United States)

    Heppe, Denise H M; Medina-Gomez, Carolina; Hofman, Albert; Franco, Oscar H; Rivadeneira, Fernando; Jaddoe, Vincent W V

    2013-07-01

    Maternal diet during pregnancy has been suggested to influence bone health in later life. We assessed the association of maternal first-trimester dietary intake during pregnancy with childhood bone mass. In a prospective cohort study in 2819 mothers and their children, we measured first-trimester daily energy, protein, fat, carbohydrate, calcium, phosphorus, and magnesium intakes by using a food-frequency questionnaire and homocysteine, folate, and vitamin B-12 concentrations in venous blood. We measured childhood total body bone mass by using dual-energy X-ray absorptiometry at the median age of 6.0 y. Higher first-trimester maternal protein, calcium, and phosphorus intakes and vitamin B-12 concentrations were associated with higher childhood bone mass, whereas carbohydrate intake and homocysteine concentrations were associated with lower childhood bone mass (all P-trend childhood bone mass. In the fully adjusted regression model that included all dietary factors significantly associated with childhood bone mass, maternal phosphorus intake and homocysteine concentrations most-strongly predicted childhood bone mineral content (BMC) [β = 2.8 (95% CI: 1.1, 4.5) and β = -1.8 (95% CI: -3.6, 0.1) g per SD increase, respectively], whereas maternal protein intake and vitamin B-12 concentrations most strongly predicted BMC adjusted for bone area [β = 2.1 (95% CI: 0.7, 3.5) and β = 1.8 (95% CI: 0.4, 3.2) g per SD increase, respectively]. Maternal first-trimester dietary factors are associated with childhood bone mass, suggesting that fetal nutritional exposures may permanently influence bone development.

  6. Mean arterial pressure in the three trimesters of pregnancy: effects of maternal characteristics and medical history.

    Science.gov (United States)

    Wright, A; Wright, D; Ispas, C A; Poon, L C; Nicolaides, K H

    2015-06-01

    To define the contribution of maternal variables that influence the measured mean arterial pressure (MAP) in screening for pregnancy complications. Maternal characteristics and medical history were recorded, and MAP was measured, in women with a singleton pregnancy attending for three routine hospital visits at 11 + 0 to 13 + 6 weeks, 19 + 0 to 24 + 6 weeks and 30 + 0 to 34 + 6 weeks or 35 + 0 to 37 + 6 weeks' gestation. For pregnancies delivering phenotypically normal live births or stillbirths at ≥ 24 weeks' gestation, variables from maternal demographic characteristics and medical history that are important in the prediction of MAP were determined from linear mixed-effects multiple regression analysis. MAP was measured in 75 841 cases in the first trimester, 30 447 in the second trimester and 31 673 in the third trimester. Significant independent contributions to MAP were provided by gestational age, maternal age, weight, height, Afro-Caribbean racial origin, cigarette smoking, family history of pre-eclampsia (PE), history of PE in the previous pregnancy, interpregnancy interval, chronic hypertension and diabetes mellitus. The effects of some variables were similar, and for others differed, in the three different trimesters. Random-effects multiple regression analysis was used to define the contribution of maternal variables that influence the measured MAP and express the values as multiples of the median (MoMs). The model was shown to provide an adequate fit of MoM values for all covariates, both in pregnancies that developed PE and in those without this complication. A model was fitted to express the measured MAP as MoMs after adjustment for variables from maternal characteristics and medical history that affect this measurement. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd.

  7. PREVALENCE OF HYPOTHYROIDISM AND SCREENING OF THYROID DYSFUNCTION DURING FIRST TRIMESTER OF PREGNANCY AT PHC

    Directory of Open Access Journals (Sweden)

    Anjali Hemant

    2016-03-01

    Full Text Available Hypothyroidism is one of the commonest endocrine disorders in pregnant women. The present study indicates a prevalence of hypothyroidism in more than 10% of pregnant women. Our study endorses the need for early antenatal screening of pregnant women in first trimester itself. If hypothyroidism is diagnosed in early pregnancy and is adequately treated and monitored, good maternal and foetal outcome is expected.

  8. Hydrothermal degradation of a 3Y-TZP translucent dental ceramic: A comparison of numerical predictions with experimental data after 2 years of aging.

    Science.gov (United States)

    Cattani-Lorente, Maria; Durual, Stéphane; Amez-Droz, Michel; Wiskott, H W Anselm; Scherrer, Susanne S

    2016-03-01

    The purpose of the study was to assess the hydrothermal resistance of a translucent zirconia with two clinical relevant surface textures by means of accelerated tests (LTD) and to compare predicted monoclinic fractions with experimental values measured after two years aging at 37°C. Polished (P) and ground (G) specimens were subjected to hydrothermal degradation by exposure to water steam at different temperatures and pressures. The t-m phase transformation was quantified by grazing incidence X-ray diffraction (GIXDR). The elastic modulus and hardness before- and after LTD were determined by nanoindentation. G specimens presented a better resistance to hydrothermal degradation than P samples. Activation energies of 89 and 98kJ/mol and b coefficients of 2.0×10(-5) and 1.8×10(-6) were calculated for P and G samples respectively. The coefficients were subsequently used to predict transformed monoclinic fractions at 37°C. A good correlation was found between the predicted values and the experimental data obtained after aging at 37°C during 2 years. Hydrothermal degradation led to a significant decrease of the elastic moduli and hardness in both groups. The dependency of the t-m phase transformation rate on temperature must be determined to accurately predict the hydrothermal behavior of the zirconia ceramics at oral temperatures. The current prevailing assumption, that 5h aging at 134°C corresponds to 15-20 years at 37°C, will underestimate the transformed fraction of the translucent ceramic at 37°C. In this case, the mechanical surface treatment influences the ceramic's transformability. While mild grinding could potentially retard the hydrothermal transformation, polishing after occlusal adjustment is recommended to prevent wear of the antagonist teeth and maintain structural strength. Copyright © 2015 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

  9. The role of histopathological examination of the products of conception following first-trimester miscarriage in Erbil Maternity Hospital

    OpenAIRE

    Payman Anwar Rashid

    2017-01-01

    Background and objective: Miscarriage represents a common problem that occurs in the first trimester of pregnancy. There is no general agreement on the value of submitting tissues from uterine evacuation in cases of miscarriage for histopathological examination. This study aimed to evaluate the role of histopathological examination in cases of first-trimester miscarriage. Methods: This is a descriptive study was carried out over a period of 14 months, from January 2015 to March 2016, at E...

  10. Potential Value of Coagulation Parameters for Suggesting Preeclampsia During the Third Trimester of Pregnancy.

    Science.gov (United States)

    Chen, Ying; Lin, Li

    2017-07-01

    Preeclampsia is a relatively common complication of pregnancy and considered to be associated with different degrees of coagulation dysfunction. This study was developed to evaluate the potential value of coagulation parameters for suggesting preeclampsia during the third trimester of pregnancy. Data from 188 healthy pregnant women, 125 patients with preeclampsia in the third trimester and 120 age-matched nonpregnant women were analyzed. Prothrombin time, prothrombin activity, activated partial thromboplastin time, fibrinogen (Fg), antithrombin, platelet count, mean platelet volume, platelet distribution width and plateletcrit were tested. All parameters, excluding prothrombin time, platelet distribution width and plateletcrit, differed significantly between healthy pregnant women and those with preeclampsia. Platelet count, antithrombin and Fg were significantly lower and mean platelet volume and prothrombin activity were significantly higher in patients with preeclampsia (P preeclampsia was 0.872 for Fg with an optimal cutoff value of ≤2.87g/L (sensitivity = 0.68 and specificity = 0.98). For severe preeclampsia, the area under the curve for Fg reached up to 0.922 with the same optimal cutoff value (sensitivity = 0.84, specificity = 0.98, positive predictive value = 0.96 and negative predictive value = 0.93). Fg is a biomarker suggestive of preeclampsia in the third trimester of pregnancy, and our data provide a potential cutoff value of Fg ≤ 2.87g/L for screening preeclampsia, especially severe preeclampsia. Copyright © 2017 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.

  11. Peripheral blood cell microRNA quantification during the first trimester predicts preeclampsia: Proof of concept.

    Directory of Open Access Journals (Sweden)

    Edward E Winger

    Full Text Available We investigated the capacity of microRNAs isolated from peripheral blood buffy coat collected late during the first trimester to predict preeclampsia.The cohort study comprised 48 pregnant women with the following pregnancy outcomes: 8 preeclampsia and 40 with normal delivery outcomes. Quantitative rtPCR was performed on a panel of 30 microRNAs from buffy coat samples drawn at a mean of 12.7±0.5 weeks gestation. MicroRNA Risk Scores were calculated and AUC-ROC calculations derived.The AUC-ROC for preeclampsia risk was 0.91 (p<0.0001. When women with normal delivery and high-risk background (those with SLE/APS, chronic hypertension and/or Type 2 Diabetes were compared to women who developed preeclampsia but with a normal risk background (without these mentioned risk factors, preeclampsia was still predicted with an AUC-ROC of 0.92 (p<0.0001.MicroRNA quantification of peripheral immune cell microRNA provides sensitive and specific prediction of preeclampsia in the first trimester of pregnant women. With this study, we extend the range during which disorders of the placental bed may be predicted from early to the end of the first trimester. This study confirms that buffy coat may be used as a sample preparation.

  12. Nursing care for patients with placenta previa undergoing interventional therapy in the second trimester of pregnancy

    International Nuclear Information System (INIS)

    Pan Suzhao; Lu Aijin; Wang Xuezhen

    2009-01-01

    Objective: To discuss the nursing care for patients with placenta previa,who receive uterine arterial catheterization and embolization in the second trimester of pregnancy. Methods: By using superselective catheterization with Seldinger technique, bilateral uterine artery angiography and embolization were performed in 16 patients with placenta previa in the second trimester of pregnancy. Two to four hours after the procedure, rivanol intra-amniotic injection was employed to induce the abortion. Close perioperative observation and careful nursing were carried out. Results: The fetus with its subsidiary tissue was delivered in a mean time of 4.5 hours after the operation in 15 cases. No postpartum hemorrhage occurred. Induced abortion failed in one case with 26 weeks pregnancy because of a scar uterus and cervical dystocia. Hysterotomy was performed 6 days later, blood loss during the operation was about 100 ml. No nursing care related complications occurred in all 16 patients. Conclusion: Uterine arterial embolization is very helpful in making the induced abortion for the treatment of bleeding placenta previa in the second trimester of pregnancy. Strengthening of perioperative care can improve successful rate of interventional therapy and prevent the occurrence of complication. (authors)

  13. The use of misoprostol in termination of second-trimester pregnancy

    Directory of Open Access Journals (Sweden)

    Chen-Ju Lin

    2011-09-01

    Full Text Available Misoprostol, a synthetic prostaglandin E1 analog, is initially used to prevent peptic ulcer. The initial US Food and Drug Administration-approved indication in the product labeling is the treatment and prevention of intestinal ulcer disease resulting from nonsteroidal anti-inflammatory drugs use. In recent two decades, misoprostol has approved to be an effective agent for termination of pregnancy in various gestation, cervical ripening, labor induction in term pregnancy, and possible management of postpartum hemorrhage. For the termination of second-trimester pregnancy using the combination of mifepristone and misoprostol seems to have the highest efficacy and the shortest time interval of abortion. When mifepristone is not available, misoprostol alone is a good alternative. Misoprostol, 400 μg given vaginally every 3–6 hours, is probably the optimal regimen for second-trimester abortion. More than 800 μg of misoprostol is likely to have more side effects, especially diarrhea. Although misoprostol can be used in women with scarred uterus for termination of second-trimester pregnancy, it is recommended that women with a scarred uterus should receive lower doses and do not double the dose if there is no initial response. It is also important for us to recognize the associated teratogenic effects of misoprostol and thorough consultation before prescribing this medication to patients regarding these risks, especially when failure of abortion occurs, is needed.

  14. The Roles of Formaldehyde Exposure and Oxidative Stress in Fetal Growth in the Second Trimester.

    Science.gov (United States)

    Amiri, Azita; Turner-Henson, Anne

    To examine the relationship between formaldehyde exposure and fetal growth in the second trimester and the potential mediating role of oxidative stress in this relationship. A cross-sectional study was conducted. The participants were recruited from one university-related clinic and two private obstetrics and gynecology offices in the Southeastern United States. A convenience sample of 140 healthy pregnant women in the second trimester of pregnancy was enrolled from November 2013 through June 2014. Formaldehyde exposure was measured via vapor monitors worn by the participants for 24 hours. One-time urine samples were collected during a routine prenatal visit to measure the level of 15-isoprostane F 2t and cotinine as biomarkers of oxidative stress and tobacco smoking, respectively. Urine creatinine was measured to standardize the cotinine and 15-isoprostane F 2t levels. Eighty-eight participants (63%) returned their formaldehyde monitors. The linear regression model showed that the dichotomized level of formaldehyde exposure (0.03 ppm) was a significant predictor of biparietal diameter percentile after controlling for maternal race (p formaldehyde exposure and biparietal diameter was not confirmed. A relationship was found between formaldehyde exposure and biparietal diameter in the second trimester. Although further research is necessary to confirm the results of this study, nurses may consider advising pregnant women to limit their exposure to formaldehyde during pregnancy. Copyright © 2017 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.

  15. Assessment of iodine nutrition in pregnant north Indian subjects in three trimesters

    Directory of Open Access Journals (Sweden)

    Emmy Grewal

    2013-01-01

    Full Text Available Objective: The cross-sectional study was carried out to assess the iodine status of pregnant women, using median urinary iodine concentration (MUI as the measure of outcome, to document the impact of advancing gestation on the MUI in normal pregnancy. Materials and Methods: The present study assessed the MUI in casual urine samples from 50 pregnant subjects of each trimester and 50 age-matched non-pregnant controls. Results: The median (range of urinary iodine concentration (UIC in pregnant women was 304 (102-859 μg/L and only 2% of the subjects had prevalence of values under 150 μg/L (iodine insufficiency. With regard to the study cohort, median (range UIC in the first, second, and third trimesters was 285 (102-457, 318 (102-805, and 304 (172-859 μg/L, respectively. Differences between the first, second, and third trimesters were not statistically significant. The MUI in the controls (305 μg/L was not statistically different from the study cohort. Conclusion: The pregnant women had no iodine deficiency, rather had high median urinary iodine concentrations indicating more than adequate iodine intake. Larger community-based studies are required in iodine-sufficient populations, to establish gestation-appropriate reference ranges for UIC in pregnancy.

  16. Committee Opinion Summary No. 638: First-Trimester Risk Assessment for Early-Onset Preeclampsia.

    Science.gov (United States)

    2015-09-01

    Hypertensive disorders with adverse sequelae (including preterm birth, maternal morbidity and mortality, and long-term risk of maternal cardiovascular disease) complicate 5-10% of pregnancies. Early identification of pregnant women at risk of developing early-onset preeclampsia would theoretically allow referral for more intensive surveillance or application of preventive therapies to reduce the risk of severe disease. In practice, however, the effectiveness of such triage would be hindered by the low positive predictive value for early-onset preeclampsia reported in the literature. In spite of the modest predictive value of first-trimester preeclampsia risk assessment and the lack of data demonstrating improved clinical outcomes, commercial tests are being marketed for the prediction of preeclampsia in the first trimester. Taking a detailed medical history to evaluate for risk factors is currently the best and only recommended screening approach for preeclampsia; it should remain the method of screening for preeclampsia until studies show that aspirin or other interventions reduce the incidence of preeclampsia for women at high risk based on first-trimester predictive tests.

  17. Revisiting the Role of First Trimester Homocysteine as an Index of Maternal and Fetal Outcome

    Science.gov (United States)

    Habeebullah, Syed; Sridhar, M. G.

    2014-01-01

    Aim. To revisit the role of first trimester homocysteine levels with the maternal and fetal outcome. Methods. This was a cohort study comprising 100 antenatal women between 8 and 12 weeks of gestation. Serum homocysteine levels were checked after overnight fasting. Results. There were significantly elevated homocysteine levels among women with prior history of hypertensive disorders of pregnancy and prior second or third trimester pregnancy losses. There was no significant difference in homocysteine levels among women with previous gestational diabetes mellitus, preterm deliveries, or fetal malformations. Homocysteine levels were significantly elevated in those who developed hypertensive disorder of pregnancy, oligohydramnios, and meconium stained amniotic fluid, had a pregnancy loss, or delivered a low birth weight baby. There was no significant difference in homocysteine levels for those who developed gestational diabetes mellitus. Conclusions. Increased first trimester serum homocysteine is associated with history of pregnancy losses, hypertensive disorders of pregnancy, and preterm birth. This is also associated with hypertensive disorders of pregnancy, pregnancy loss, oligohydramnios, meconium stained amniotic fluid, and low birth weight in the current pregnancy. This trial is registered with ClinicalTrials.gov CTRI/2013/02/003441. PMID:24883207

  18. Analytical goal setting in aneuploidy screening: within person biological variability of first trimester biochemical markers.

    Science.gov (United States)

    Spencer, Kevin; Cowans, Nicholas J

    2013-02-01

    To determine the average within person biological variability of free-β human chorionic gonadotrophin (free hCGβ), intact hCG and pregnancy-associated plasma protein A (PAPP-A), and to establish analytical goals for the measurement of these markers when used in first trimester screening. Free hCGβ, PAPP-A and intact hCG were measured on paired first trimester samples collected during the same pregnancy. Results were converted to Multiple of the Median (MoMs).The overall total variation at each day log was determined from a correlation of the marker MoMs in the log domain. Biological variation was calculated after taking into account analytical variation. The within person biological variability for free hCGβ varied from 1.30% at 2 days separation to 5.25% at 5 days. For PAPP-A this was 1.96% and 5.03%, respectively, and for intact hCG this was 14.59% and 21.09%. All markers exhibit a rapid increase in biological variability as the time separation increased. Setting analytical goals for precision of measurement of first trimester biochemical markers from within person biological variability would suggest that free hCGβ and PAPP-A needs to be measured with a precision of 2.5%, targets close to those set empirically by the Fetal Medicine Foundation and achieved in practice by some analytical system in routine use. © 2012 John Wiley & Sons, Ltd.

  19. Detection Rates for Aneuploidy by First-Trimester and Sequential Screening.

    Science.gov (United States)

    Baer, Rebecca J; Flessel, Monica C; Jelliffe-Pawlowski, Laura L; Goldman, Sara; Hudgins, Louanne; Hull, Andrew D; Norton, Mary E; Currier, Robert J

    2015-10-01

    To estimate detection rates for aneuploidy by first-trimester and sequential screening. The study included women with singleton pregnancies who participated in the California Prenatal Screening Program with estimated delivery dates from August 2009 to December 2012 who had first- or first- and second-trimester (sequential) screening. Detection rates were measured for target (trisomies 21 and 18) and other aneuploidies identified from the California Chromosome Defect Registry. Of 452,901 women screened, 17,435 (3.8%) were screen-positive for Down syndrome only; 433 (0.1%) for trisomy 18 only; 1,689 (0.4%) for both Down syndrome and trisomy 18; and 2,947 (0.7%) for neural tube defects, Smith-Lemli-Opitz syndrome, or for multiple conditions. The detection rates were Down syndrome-92.9% (95% confidence interval [CI] 91.4-94.2); trisomy 18-93.2% (95% CI 90.5-95.9); trisomy 13-80.4% (95% CI 73.9-86.9); 45,X-80.1% (95% CI 73.9-86.3), and triploidy-91.0% (95% CI 84.2-97.9). Overall, the detection rate for chromosome abnormalities was 81.6% (95% CI 80.0-83.1) at an overall false-positive rate of 4.5%. First-trimester and sequential screening are sensitive and specific for the broad range of karyotype abnormalities seen in the population. II.

  20. Construction of modern Australian first trimester ultrasound dating and growth charts

    International Nuclear Information System (INIS)

    McLennan, A. C.; Schluter, P. J.; and the University of Queensland, Brisbane, Queensland Australia

    2008-01-01

    Full text: Accurate pregnancy dating is vital to obstetric management. However, first trimester fetal charts commonly used in Australia rely on data reported more than three decades ago. This study reports first trimester dating and growth charts for crown-rump length between 5 and 14 weeks of gestation and biparietal diameter between 9 and 14 weeks of gestation on an Australia population using modern real-time ultrasound equipment. All consenting eligible women attending a large Sydney clinic for first trimester ultrasound between March 2005 and December 2006 were recruited. Measurements were carried out to Australasian Society for Ultrasound in Medicine standard protocols. Statistical analyses were undertaken using polynomial regression models and thorough diagnostic checks made. Overall 396 eligible women consented to the study, with 268 between 9 and 14 weeks of gestation. The average participant age was 34 years (range 22-45 years), 371 and all yielded valid biometry measurements. Equations, means and 90% reference intervals for crown-rump length measurements and biparietal diameter measurements were derived using polynomial regression models. Thorough residual and diagnostic checks were made. Once validated by others, we believe they will warrant consideration for use by Australasian Society for Ultrasound in Medicine.

  1. Understanding women's desires for contraceptive counseling at the time of first-trimester surgical abortion.

    Science.gov (United States)

    Matulich, Melissa; Cansino, Catherine; Culwell, Kelly R; Creinin, Mitchell D

    2014-01-01

    The objective was to investigate whether or not women presenting for a first-trimester surgical abortion want to discuss contraception on the day of their procedure. Between October 2012 and January 2013, an anonymous self-administered survey was distributed to women receiving first-trimester surgical abortions at four northern California family planning clinics. The survey obtained demographic information about each woman and inquired about her desire for contraceptive counseling during her appointment. Results were analyzed using both univariate and multivariable regression analyses to assess trends in responses related to desire for contraceptive counseling based on demographic and other variables. Of the 199 respondents, 64% reported that they did not want to talk to a counselor or doctor about contraception on the day of their abortion. About half of the women (52%) who did not want to discuss contraception indicated they already knew what they wanted for pregnancy prevention. Of the 25% who reported that they did want to discuss contraception, the most important topic desired from the counseling was identification of methods that were easier to use than what they used previously. The majority of women seeking first-trimester surgical abortion may not desire additional information about contraception on the day of the procedure. This study demonstrates that a significant proportion of women may not want contraceptive counseling on the day of a planned surgical abortion. © 2013.

  2. After After Tiller: the impact of a documentary film on understandings of third-trimester abortion.

    Science.gov (United States)

    Sisson, Gretchen; Kimport, Katrina

    2016-01-01

    Onscreen pseudo-experiences have been shown to influence public perceptions of contested social issues. However, research has not considered whether such experiences have limits in their influence and/or vary in their impact. Using the case of third-trimester abortion, an issue subject to high amounts of misinformation, low public support and low occurrence in the general population, we investigate how the pseudo-experience of viewing After Tiller, a documentary film showing stories of third-trimester abortion, providers and patients, might serve as a counterpoint to misinformation and myth. We interviewed 49 viewers to assess how viewing the film interacted with viewers' previously held understandings of later abortion. Participants reported that viewing made them feel more knowledgeable about later-abortion patients and providers and increased their support for legal third-trimester abortion access, suggesting the efficacy of this pseudo-experience in changing belief. Nonetheless, respondents' belief systems were not entirely remade and the effects of the film varied, particularly in regards to gatekeeping around the procedure and the reasons why women seek later abortion. Findings show the potential of onscreen pseudo-experiences as a means for social change, but also reveal their limits and varying impacts.

  3. [Behaviour and attitudes towards the sexuality of the pregnant woman during the last trimester. Phenomenological study].

    Science.gov (United States)

    Panea Pizarro, Isabel; Domínguez Martin, Ana Teresa; Barragán Prieto, Vanessa; Martos Sánchez, Almudena; López Espuela, Fidel

    2018-04-13

    To explore the life experiences on sexual relationships in the third trimester of pregnancy in primiparous women. Phenomenological qualitative study, SITE: Cáceres (Extremadura). Primiparous women in the third trimester of their pregnancy. We use theoretical sampling, was conducted on pregnant primiparous. The study included 15 participants. The data was collected using in-depth interviews, that were voiced recorded and later transcribed. The analysis was made using Giorgi's proposal. The results show three main points. Fear of doing damage, mediated by the obstetric history and the desire to have the long-awaited child. Exploring new routes: forms of sexual expression are modified by the physical changes, the fears, and the mobility. Highlighting the importance of other displays of affection and love (kisses and caresses). The Sex Taboo: lack of information against sexuality during pregnancy is still common. Women in the third trimester of their pregnancy put aside their sexual appetite and that of their partners, and concentrate in the wellbeing of their new born baby. It highlights the role of the mother before the couple. The more desired and difficult the pregnancy has been, the more the sexual life is reduced. The Health Professionals must advise and inform the couples with an open-minded attitude. Copyright © 2018 The Authors. Publicado por Elsevier España, S.L.U. All rights reserved.

  4. Regionally-specified second trimester fetal neural stem cells reveals differential neurogenic programming.

    Directory of Open Access Journals (Sweden)

    Yiping Fan

    Full Text Available Neural stem/progenitor cells (NSC have the potential for treatment of a wide range of neurological diseases such as Parkinson Disease and multiple sclerosis. Currently, NSC have been isolated only from hippocampus and subventricular zone (SVZ of the adult brain. It is not known whether NSC can be found in all parts of the developing mid-trimester central nervous system (CNS when the brain undergoes massive transformation and growth. Multipotent NSC from the mid-trimester cerebra, thalamus, SVZ, hippocampus, thalamus, cerebellum, brain stem and spinal cord can be derived and propagated as clonal neurospheres with increasing frequencies with increasing gestations. These NSC can undergo multi-lineage differentiation both in vitro and in vivo, and engraft in a developmental murine model. Regionally-derived NSC are phenotypically distinct, with hippocampal NSC having a significantly higher neurogenic potential (53.6% over other sources (range of 0%-27.5%, p<0.004. Whole genome expression analysis showed differential gene expression between these regionally-derived NSC, which involved the Notch, epidermal growth factor as well as interleukin pathways. We have shown the presence of phenotypically-distinct regionally-derived NSC from the mid-trimester CNS, which may reflect the ontological differences occurring within the CNS. Aside from informing on the role of such cells during fetal growth, they may be useful for different cellular therapy applications.

  5. Sequential combined test, second trimester maternal serum markers, and circulating fetal cells to select women for invasive prenatal diagnosis.

    Directory of Open Access Journals (Sweden)

    Paolo Guanciali Franchi

    Full Text Available From January 1st 2013 to August 31st 2016, 24408 pregnant women received the first trimester Combined test and contingently offered second trimester maternal serum screening to identify those women who would most benefit from invasive prenatal diagnosis (IPD. The screening was based on first trimester cut-offs of ≥1:30 (IPD indicated, 1:31 to 1:899 (second trimester screening indicated and ≤1:900 (no further action, and a second trimester cut-off of ≥1:250. From January 2014, analysis of fetal cells from peripheral maternal blood was also offered to women with positive screening results. For fetal Down syndrome, the overall detection rate was 96.8% for a false-positive rate of 2.8% resulting in an odds of being affected given a positive result (OAPR of 1:11, equivalent to a positive predictive value (PPV of 8.1%. Additional chromosome abnormalities were also identified resulting in an OAPR for any chromosome abnormality of 1:6.6 (PPV 11.9%. For a sub-set of cases with positive contingent test results, FISH analysis of circulating fetal cells in maternal circulation identified 7 abnormal and 39 as normal cases with 100% specificity and 100% sensitivity. We conclude that contingent screening using conventional Combined and second trimester screening tests is effective but can potentially be considerably enhanced through the addition of fetal cell analysis.

  6. Slow fetal growth between first and early second trimester ultrasound scans and risk of small for gestational age (SGA birth.

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    Marija Simic

    Full Text Available To investigate the association between fetal growth between first and early second trimester ultrasound scan and the risk of severe small for gestational age (SGA birth.This cohort study included 69 550 singleton pregnancies with first trimester dating and an early second trimester growth scan in Stockholm and Gotland Counties, Sweden between 2008 and 2014. Exposure was difference in biparietal diameter growth between observed and expected at the second trimester scan, calculated by z-scores. Risk of birth of a severe SGA infant (birth weight for gestational age by fetal sex less than the 3rd centile was calculated using multivariable logistic regression analysis and presented as adjusted odds ratio (aOR.Parietal growth less than 2.5 percentile between first and second trimester ultrasound examination was associated with elevated risk of being born severe SGA. (aOR 1.67; 95% Confidence Interval 1.28-2.18. The risks of preterm severe SGA (birth before 37 weeks and term severe SGA (birth 37 weeks or later were at similar levels, and risk of severe SGA were also elevated in the absence of preeclampsia, hypertensive diseases or gestational diabetes.Fetuses with slow growth of biparietal diameter at ultrasound examination in early second trimester exhibit increased risk of being born SGA independent of gestational age at birth and presence of maternal hypertensive diseases or diabetes mellitus.

  7. Slow fetal growth between first and early second trimester ultrasound scans and risk of small for gestational age (SGA) birth.

    Science.gov (United States)

    Simic, Marija; Stephansson, Olof; Petersson, Gunnar; Cnattingius, Sven; Wikström, Anna-Karin

    2017-01-01

    To investigate the association between fetal growth between first and early second trimester ultrasound scan and the risk of severe small for gestational age (SGA) birth. This cohort study included 69 550 singleton pregnancies with first trimester dating and an early second trimester growth scan in Stockholm and Gotland Counties, Sweden between 2008 and 2014. Exposure was difference in biparietal diameter growth between observed and expected at the second trimester scan, calculated by z-scores. Risk of birth of a severe SGA infant (birth weight for gestational age by fetal sex less than the 3rd centile) was calculated using multivariable logistic regression analysis and presented as adjusted odds ratio (aOR). Parietal growth less than 2.5 percentile between first and second trimester ultrasound examination was associated with elevated risk of being born severe SGA. (aOR 1.67; 95% Confidence Interval 1.28-2.18). The risks of preterm severe SGA (birth before 37 weeks) and term severe SGA (birth 37 weeks or later) were at similar levels, and risk of severe SGA were also elevated in the absence of preeclampsia, hypertensive diseases or gestational diabetes. Fetuses with slow growth of biparietal diameter at ultrasound examination in early second trimester exhibit increased risk of being born SGA independent of gestational age at birth and presence of maternal hypertensive diseases or diabetes mellitus.

  8. Trimester-specific reference intervals for haemoglobin A(1c) (HbA(1c)) in pregnancy.

    LENUS (Irish Health Repository)

    O'Connor, Catherine

    2011-11-26

    Abstract Background: Diabetes in pregnancy imposes additional risks to both mother and infant. These increased risks are considered to be primarily related to glycaemic control which is monitored by means of glycated haemoglobin (HbA(1c)). The correlation of HbA(1c) with clinical outcomes emphasises the need to measure HbA(1c) accurately, precisely and for correct interpretation, comparison to appropriately defined reference intervals. Since July 2010, the HbA(1c) assay in Irish laboratories is fully metrologically traceable to the IFCC standard. The objective was to establish trimester-specific reference intervals in pregnancy for IFCC standardised HbA(1c) in non-diabetic Caucasian women. Methods: The authors recruited 311 non-diabetic Caucasian pregnant (n=246) and non-pregnant women (n=65). A selective screening based on risk factors for gestational diabetes was employed. All subjects had a random plasma glucose <7.7 mmol\\/L and normal haemoglobin level. Pregnancy trimester was defined as trimester 1 (T1, n=40) up to 12 weeks +6 days, trimester 2 (T2, n=106) 13-27 weeks +6 days, trimester 3 (T3, n=100) >28 weeks to term. Results: The normal HbA(1c) reference interval for Caucasian non-pregnant women was 29-37 mmol\\/mol (Diabetes Control and Complications Trial; DCCT: 4.8%-5.5%), T1: 24-36 mmol\\/mol (DCCT: 4.3%-5.4%), T2: 25-35 mmol\\/mol (DCCT: 4.4%-5.4%) and T3: 28-39 mmol\\/mol (DCCT: 4.7%-5.7%). HbA(1c) was significantly decreased in trimesters 1 and 2 compared to non-pregnant women. Conclusions: HbA(1c) trimester-specific reference intervals are required to better inform the management of pregnancies complicated by diabetes.

  9. [Motor behavior of human fetuses during the second trimester of gestation: a longitudinal ultrasound study].

    Science.gov (United States)

    Reynoso, C; Crespo-Eguílaz, N; Alcázar, J L; Narbona, J

    2015-03-01

    The aim of this research is to contribute to knowledge of the normal spontaneous motor behavior of the human fetus during the second trimester of pregnancy. This study focuses on five patterns of spontaneous fetal movement: startle (S), axo-rhizomelic rhythmia (ARR), axial stretching (AS), general movement (GM), and diaphragmatic contraction (DC). A cohort of 13 subjects was followed up using 2D obstetrical ultrasound images at 12, 16, 20, and 24 weeks of gestation. As inclusion criteria, neonatal neurological examination and general movements after eutocic delivery at term were normal in all of the subjects, and their neuromotor and cognitive development until the end of pre-school age were also normal. All these five motor patterns are present at the beginning of the 2(nd) gestational trimester, but their quantitative and qualitative traits are diverse according to gestational ages. The phasic, isolated or rhythmically repeated movements, S and ARR, are prominent at 12 and 16 weeks of gestation, and then their presence gradually diminishes. By contrast, tonic and complex AS and GM movements increase their presence and quality at 20 and 24 weeks. RAR constitute a particular periodic motor pattern not described in previous literature. Moreover, the incidence of DC is progressive throughout the trimester, in clusters of 2-6 arrhythmic and irregular beats. Fetal heart rate increases during fetal motor active periods. All five normal behavioral patterns observed in the ultrasounds reflect the progressive tuning of motor generators in human nervous system during mid-pregnancy. Copyright © 2014 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.

  10. Proteomic Analysis of Early Mid-Trimester Amniotic Fluid Does Not Predict Spontaneous Preterm Delivery

    Science.gov (United States)

    Lenco, Juraj; Vajrychova, Marie; Link, Marek; Tambor, Vojtech; Liman, Victor; Bullarbo, Maria; Nilsson, Staffan; Tsiartas, Panagiotis; Cobo, Teresa; Kacerovsky, Marian; Jacobsson, Bo

    2016-01-01

    Objective The aim of this study was to identify early proteomic biomarkers of spontaneous preterm delivery (PTD) in mid-trimester amniotic fluid from asymptomatic women. Methods This is a case-cohort study. Amniotic fluid from mid-trimester genetic amniocentesis (14–19 weeks of gestation) was collected from 2008 to 2011. The analysis was conducted in 24 healthy women with subsequent spontaneous PTD (cases) and 40 randomly selected healthy women delivering at term (controls). An exploratory phase with proteomics analysis of pooled samples was followed by a verification phase with ELISA of individual case and control samples. Results The median (interquartile range (IQR: 25th; 75th percentiles) gestational age at delivery was 35+5 (33+6–36+6) weeks in women with spontaneous PTD and 40+0 (39+1–40+5) weeks in women who delivered at term. In the exploratory phase, the most pronounced differences were found in C-reactive protein (CRP) levels, that were approximately two-fold higher in the pooled case samples than in the pooled control samples. However, we could not verify these differences with ELISA. The median (25th; 75th IQR) CRP level was 95.2 ng/mL (64.3; 163.5) in women with spontaneous PTD and 86.0 ng/mL (51.2; 145.8) in women delivering at term (p = 0.37; t-test). Conclusions Proteomic analysis with mass spectrometry of mid-trimester amniotic fluid suggests CRP as a potential marker of spontaneous preterm delivery, but this prognostic potential was not verified with ELISA. PMID:27214132

  11. First trimester sonography: effective in reducing of post term pregnancy rate

    Directory of Open Access Journals (Sweden)

    Behdani R

    2008-06-01

    Full Text Available Background: Approximately 10 percent of all pregnancies continue to 42 weeks'gestation. The true prevalence of pregnancies lasting longer than 41 or 42 weeks'gestation has been difficult to establish because many such diagnoses occur as a result of an inability to accurately establish time of conception. Several studies indicate that menstrual dating is often inaccurate and can lead to induction of labor for a presumed but inaccurate diagnosis of postterm pregnancy. It is now widely accepted that a more precise method of determining gestational age is the first trimester measurement of crown-rump length of the fetus.Methods: We carried out a cross- sectional study on patients who were referred for a prenatal care to Arash hospital, Medical Sciences/University of Tehran. Women in the first trimester of pregnancy who presented to the center during the study period with precise  date of last menstrual period were eligible to enroll. They underwent an ultrasound dating scan between 8 and 12 weeks, measuring crown-rump length. The estimated date of delivery (EDD was changed if there was a discrepancy of more than 5 days from the gestation, calculated from the last menstrual period (LMP. For the remaining women (no-scan group, gestation was determined using the LMP. Data were analyzed using SPSS, 11. Statistical significance was assessed with Chi-square, student t-test and Anova, using a significance threshold of < 0.05.Results: Of 217 women who were enrolled, 10.6% of the patients who underwent an ultrasound dating scan were postdate versus 3.7% of the patients whose gestational age calculated from LMP (p=0.005.Conclusions: The application of first trimester sonographic measurement of crown-rump length of the fetus results in a significant reduction of the diagnosis of postterm pregnancies.

  12. Comparison of oral and vaginal misoprostol for cervical ripening before evacuation of first trimester missed miscarriage

    International Nuclear Information System (INIS)

    Jabir, Maysoon M.; Smeet, Rania I.

    2009-01-01

    Objective was to assess the effectiveness of misoprostol in cervical ripening before evacuation of conception in the first trimester missed miscarriages and to compare between oral and vaginal routes of administration. A randomized control study was carried out in Baghdad Teaching Hospital, Baghdad, Iraq in 2006. One hundred and twenty women with first fist trimester missed miscarriages were divided into 2 study groups, randomized for oral and vaginal (400 mcg) misoprostol priming of cervix and 2 control groups randomized for oral and vaginal placebo, before undergoing surgical evacuation of conception after 3 hours. Measured outcomes were: post medication cervical dilatation, time needed to dilate the cervix surgically, blood loss and developments of the side effects of misoprostol. Post medication cervical dilation was higher in the misoprostol group (7.07+-1.36 mm for oral misoprostol, 7.77+-1.22 mm for vaginal misoprostol), versus the control groups (2.43+-0.5 mm). Post medication cervical dilatation was significantly higher in the vaginal misoprostol group, compared to the oral group (p=0.04). The time required to dilate the cervix in the misoprostol group was shorter, compared with placebo. There were no significant differences in the amount of blood loss between oral (p=0.074) and vaginal misoprostol groups (p=0.62) and gastrointestinal side effects were significantly more in the oral misoprostol group (p=0.014). Misoprostol is an effective cervical priming agent when administered either orally or vaginally before evacuation of conception in the termination of the first trimester missed miscarriage. (author)

  13. Comparison of manual vacuum aspiration and sharp curettage in the treatment of first trimester abortions

    International Nuclear Information System (INIS)

    Iftikhar, G.; Tanveer, S.; Gilani, T.A.; Gilani, S.T.A.

    2014-01-01

    To compare the safety and efficacy of manual vacuum aspiration and sharp curettage in the treatment of first trimester abortions. Study Design: Randomized controlled trial. Place and Duration of Study: Department of Gynecology, Social Security Hospital Shahdra Lahore in collaboration with Family Health Hospital Johar Town Lahore, from May 2007 to May 2012. Patients and Methods: Six hundred women admitted with the diagnosis of first trimester less than or equal to 12 weeks abortions were randomly assigned, 300 to manual vacuum aspiration (MVA) and 300 to traditional sharp curettage. Diagnosis of abortion was confirmed by last menstrual period, physical examination and ultrasonography. Results: In total of 600 patients, 300 randomly assigned to MVA and another 300 patients assigned to sharp curettage management were having mean age of 31.8 and 33 yrs respectively. Mean parity was in both groups, mean gestational age 8.9 and 8.2 weeks, mean duration of procedure was 6.4 and 5.8 minutes, duration of hospital stay was 4 and 40 hrs, missed abortion in 47% and 43% patients, incomplete abortion in 53% and 57% patients, cervical dilatation was needed in 1% against 53%, 10% against 8 % experienced mild pain in both groups, no patient of incomplete evacuation against 0.6%, uterine perforation in none against 0.3 %, excessive bleeding was experienced by 0.3% against 0.6% patients in both groups, and patient satisfaction rate was 99% against 99.4% in the two groups respectively. Conclusion: In the management of first trimester pregnancy loss, MVA offers a quick solution to the problem with reduced hospital stay and lower rate of complications. (author)

  14. Plantar pressure and foot pain in the last trimester of pregnancy.

    Science.gov (United States)

    Karadag-Saygi, Evrim; Unlu-Ozkan, Feyza; Basgul, Alin

    2010-02-01

    Back and foot pain are common complaints during pregnancy. Progression of symptoms is seen especially in the third trimester as the center of gravity (COP) is altered due to weight gain. The aim of the study was to evaluate plantar pressure changes and postural balance differences of pregnant women. Thirty-five last trimester pregnant women with complaints of foot pain were included. The control group consisted of 35 non-pregnant women who were age and body mass index (BMI) matched volunteers. All selected cases were overweight. Foot pain in pregnancy was measured by Visual analogue scale (VAS). Percentages of pressure on forefoot and hindfoot were measured using static pedobarography and peak pressures at forefoot, midfoot and hindfoot were measured using dynamic pedobarography. As a measurement of balance, COP sway length and width were also analyzed. Compared to overweight individuals, pregnant patients had higher forefoot pressure on the right side with standing and walking. Also, significant increases in contact times under the forefoot and longer floor contact times were found. VAS scores were correlated with forefoot contact times during walking. Although the sway length from COP was higher than controls, no significant correlation was found in sway length and weight gain. These data suggest that forefoot pressures increase in the last trimester of pregnancy during standing and walking. There is prominent increased postural sway in anterior-posterior direction in this period. We believe that based on the observed pressure changes, foot pain in pregnancy due to changes in body mass and distribution may be relieved by exercise and shoewear modifications.

  15. Immunomodulatory molecules are released from the first trimester and term placenta via exosomes

    Science.gov (United States)

    Kshirsagar, S.K.; Alam, S.M.; Jasti, S.; Hodes, H.; Nauser, T.; Gilliam, M.; Billstrand, C.; Hunt, J.S.; Petroff, M.G.

    2012-01-01

    The semiallogenic fetus is tolerated by the maternal immune system through control of innate and adaptive immune responses. Trophoblast cells secrete nanometer scale membranous particles called exosomes, which have been implicated in modulation of the local and systemic maternal immune system. Here we investigate the possibility that exosomes secreted from the first trimester and term placenta carry HLA-G and B7 family immunomodulators. Confocal microscopy of placental sections revealed intracellular colocalization of B7-H1 with CD63, suggesting that B7-H1 associates with subcellular vesicles that give rise to exosomes. First trimester and term placental explants were then cultured for 24 hours. B7H-1 (CD274), B7-H3 (CD276) and HLA-G5 were abundant in pelleted supernatants of these cultures that contained microparticles and exosomes; the latter, however, was observed only in first trimester pellets and was nearly undetectable in term explant-derived pellets. Further purification of exosomes by sucrose density fractionation confirmed the association of these proteins specifically with exosomes. Finally, culture of purified trophoblast cells in the presence or absence of EGF suggested that despite the absence of HLA-G5 association with term explant-derived exosomes, it is present in exosomes secreted from mononuclear cytotrophoblast cells. Further, differentiation of cytotrophoblast cells reduced the presence of HLA-G5 in secreted exosomes. Together, the results suggest that the immunomodulatory proteins HLA-G5, B7-H1 and B7-H3, are secreted from early and term placenta, and have important implications in the mechanisms by which trophoblast immunomodulators modify the maternal immunological environment. PMID:23107341

  16. Transabdominal ultrasonography as a screening test for second-trimester placenta previa.

    Science.gov (United States)

    Quant, Hayley S; Friedman, Alexander M; Wang, Eileen; Parry, Samuel; Schwartz, Nadav

    2014-03-01

    To determine the test characteristics of transabdominal ultrasonography as a screening test for second-trimester placenta previa. This secondary analysis of a prospective cohort study evaluated the distance from the placental edge to the internal os (placenta-cervix distance) through both transabdominal and transvaginal ultrasonography during the anatomic survey. Patients were recruited in the Maternal-Fetal Medicine Ultrasound Unit at the Hospital of the University of Pennsylvania, an urban tertiary care center. Transabdominal placenta-cervix distance cutoffs with high sensitivity for detection of previa and low-lying placenta were identified, and test characteristics were calculated. Follow-up ultrasound data, pregnancy, and delivery outcomes for those with second-trimester previa or low-lying placenta were obtained. One thousand two hundred fourteen women were included in the analysis. A transabdominal placenta-cervix distance cutoff of 4.2 cm was 93.3% sensitive and 76.7% specific for detection of previa with a 99.8% negative predictive value at a screen-positive rate of 25.0%. A cutoff of 2.8 cm was 86.7% sensitive and 90.5% specific with a 99.6% negative predictive value at a screen-positive rate of 11.4%. Only 9.8% (four of 41) of previas and low-lying placentas persisted through delivery. Transabdominal ultrasonography is an effective screening test for second-trimester placenta previa. At centers not performing universal transvaginal ultrasonography at the time of the anatomic survey, evidence-based transabdominal placenta-cervix distance cutoffs can optimize the identification of patients who require further surveillance for previa.

  17. Altered Global Gene Expression in First Trimester Placentas of Women Destined to Develop Preeclampsia

    Science.gov (United States)

    Founds, Sandra A.; Conley, Yvette P.; Lyons-Weiler, James F.; Jeyabalan, Arun; Hogge, W. Allen; Conrad, Kirk P.

    2009-01-01

    Background Preeclampsia is a pregnancy-specific disorder that remains a leading cause of maternal, fetal and neonatal morbidity and mortality, and is associated with risk for future cardiovascular disease. There are no reliable predictors, specific preventative measures or treatments other than delivery. A widely-held view is that the antecedents of preeclampsia lie with impaired placentation in early pregnancy. Accordingly, we hypothesized dysregulation of global gene expression in first trimester placentas of women who later manifested preeclampsia. Methods Surplus chorionic villus sampling (CVS) tissues were collected at 10–12 weeks gestation in 160 patients with singleton fetuses. Four patients developed preeclampsia, and their banked CVS specimens were matched to 8 control samples from patients with unaffected pregnancies. Affymetrix HG-U133 Plus 2.0 GeneChips were utilized for microarray analysis. Naïve Bayes prediction modeling and pathway analysis were conducted. qRT-PCR examined three of the dysregulated genes. Results Thirty-six differentially expressed genes were identified in the preeclampsia placentas. qRT-PCR verified the microarray analysis. Thirty-one genes were down-regulated. Many were related to inflammation/immunoregulation and cell motility. Decidual gene dysregulation was prominent. No evidence was found for alterations in hypoxia and oxidative stress regulated genes. Conclusions To our knowledge, this is the first study to show dysregulation of gene expression in the early placentas of women ~6 months before developing preeclampsia, thereby reinforcing a placental origin of the disorder. We hypothesize that placentation in preeclampsia is compromised in the first trimester by maternal and fetal immune dysregulation, abnormal decidualization, or both, thereby impairing trophoblast invasion. Several of the genes provide potential targets for the development of clinical biomarkers in maternal blood during the first trimester. Supplementary

  18. Impact on obstetric outcome of third-trimester screening for small-for-gestational-age fetuses.

    Science.gov (United States)

    Callec, R; Lamy, C; Perdriolle-Galet, E; Patte, C; Heude, B; Morel, O

    2015-08-01

    To evaluate the performance of screening for small-for-gestational-age (SGA) fetuses by ultrasound biometry at 30-35 weeks' gestation, and to determine the impact of screening on obstetric and neonatal outcomes. For this prospective cohort study, pregnant women were recruited from two French university maternity centers between 2003 and 2006. Performance measures of third-trimester biometry for the prediction of SGA, defined as estimated fetal weight third-trimester ultrasound had a sensitivity of 29.0% (95% CI, 22.5-36.6%) and specificity of 94.2% (95% CI, 93.0-95.2%). Positive and negative predictive values were 30.8% (95% CI, 23.9-38.7%) and 93.7% (95% CI, 92.5-94.8%), respectively. One hundred and ten SGA neonates went undiagnosed at ultrasound. Compared to the TN neonates considered as of normal weight at ultrasound, planned preterm delivery (before 37 weeks) and elective Cesarean section for a fetal growth indication were 2.4 (P = 0.01) and 2.85 (P = 0.003) times more likely to occur, respectively, in the FP group of non-SGA neonates, diagnosed incorrectly as SGA during the antenatal period. There was no statistically significant difference in 5-min Apgar score third-trimester ultrasound screening for SGA seems poor, as it misses the diagnosis of a large number of SGA neonates. The consequences of routine screening for SGA in a low-risk population may lead to unnecessary planned preterm deliveries and elective Cesarean sections in FP pregnancies, without improved neonatal outcome in the FN pregnancies. Copyright © 2014 ISUOG. Published by John Wiley & Sons Ltd.

  19. Simulation analysis of 9033 cases of second trimester maternal serum screening for Down’s syndrome

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    Shu-fang JIANG

    2017-06-01

    Full Text Available Objective To reduce the screening positive rate (SPR and improve clinical efficiency of maternal serum screening for Down's syndrome. Methods Nine thousand and thirty-three cases of second trimester maternal serum screening for Down's syndrome were included from Apr. 2013 to Apr. 2014 in the present study. The screening results, all basic data and equation curves were analyzed retrospectively. Based on the data from the authors' laboratory, the important adjustment parameters were simulated. Combined with postnatal follow-up results, the quality and clinical performance of second trimester serum screening for Down's syndrome were evaluated. Results The SPR of second trimester serum screening for Down's syndrome was 6.69%(604/9033, the detection rate (DR was 75%(3/4, and FPR was 6.65%(601/9033. The median multiple of median (MOM of alpha-fetoprotein (AFP was low and SPR was high, and MOM of free human chorionic gonadotropin β subunit (free hCGβ were high and SPR was high, while MOM of unconjugated estriol (uE3 were a little bit low, and SPR was slightly high. Considering these three factors, it is believed that the screening positive rate is high. By the simulation adjustments of MOM value equations (AFP and free hCGβ and weight correction equation, the SPR reduced to 4.11%(371/9033 after recalculating the risk, FPR declined to 4.07%(368/9033, and no more Down's syndrome fetus were missed compared with postnatal follow-up results. Conclusion Based on a localized setting depending on the local laboratory data, we suggest that the MOM value distributions(AFP, free hCGβ and uE3 and maternal weight should be regularly adjusted since it is a useful way to reduce the false-positive rate and improve clinical efficiency of maternal serum screening for Down's syndrome. DOI: 10.11855/j.issn.0577-7402.2017.04.13

  20. COMPARISON OF MISOPROSTOL AND MISOPROSTOL WITH ISOSORBIDE MONONITRATE IN SECOND TRIMESTER TERMINATION OF PREGNANCY

    Directory of Open Access Journals (Sweden)

    Shanthi Sivakumar

    2016-08-01

    Full Text Available BACKGROUND To compare the efficacy and side effect profile of vaginal misoprostol versus misoprostol and isosorbide mononitrate in enhancing cervical ripening in second trimester pregnancy termination. METHODS It is a random clinical trial done in 100 patients for mid trimester termination of pregnancy (between 12 and 24 weeks of gestational age. They were divided into two groups: Group A Combination of 400 mcg of misoprostol and 40 mg of ISMN placed intravaginally. Repeat doses included combination of 400 mcg of misoprostol and 20 mg of ISMN every 4 hours for maximum 4 doses. Group B 400 mcg of misoprostol placed intravaginally every 4 hours for maximum 4 doses for termination. In both the above-mentioned groups, T. mifepristone 600 mg was given orally 36-48 hrs. prior to termination. RESULTS The mean induction abortion interval was significantly less (7 hrs. 36 mins in Group A compared with group B (9 hrs. 55 min. There was no statistical significant difference in the amount of mean dose used in both groups. The complete abortion rate within 48 hrs. in Group A was 94%, which shows no statistical significance when compared with Group B complete abortion rates (80%. However, it is interpreted that on adding ISMN, the number of complete abortion rates are higher. There was no failure of abortion in both the groups. The side effects such as pain abdomen and fever were less in Group A (38% when compared to Group B (78%. CONCLUSION Vaginally administered ISMN seems to be safe and effective method in second trimester pregnancy termination. There is a reduction in hospital stay, manpower, economy spent on patient, and a sense of wellbeing from the patient also.

  1. A Comparative Study of Vaginal Misoprostol and High Dose Intravenous Oxytocin for Second Trimester Pregnancy Termination

    Directory of Open Access Journals (Sweden)

    M. Rajaee

    2010-04-01

    Full Text Available Introduction & Objective: Second trimester labor induction is a major problem in obstetrics and is the cause of two-thirds of all abortion related complications and more than half of the maternal deaths associated with abortion. The goal of this study was to compare the effectiveness of vaginal misoprostol and intravenous oxytocin for termination of second trimester pregnancy.Materials & Methods: One hundred women were allocated in a randomized controlled way to one of the two induction groups: oxytocin group patients initially received an infusion of 50 units of oxytocin in 500 ml of ringer over 3 hours, 1 hour of no oxytocin followed by alternating 3 hours of oxytocin with 1 hour of rest. Oxytocin was increased by 50 units in each successive period until a final concentration of 300 units per 500 ml has been reached. Another group received 200 µg misoprostol tablets in posterior fornix vagina and was repeated after 12 hours if needed. The two groups were compared for induction to delivery intervals and their safety during induction. Results: The success rate within 24 hours of induction was 94% in the misoprostol group and 86% in oxytocin group (p= 0.182. The mean induction to delivery time was significantly longer in the oxytocin group compared with the misoprostol group.(13.5 versus 9.93 hours ; P=0.0057. Retained placenta requiring curettage was lower in the misoprostol group than the oxytocin group.Conclusion: Intravaginal misoprostol is more effective than high dose intravenous oxytocin in women with second trimester termination.

  2. A COMPARATIVE STUDY OF MIFEPRISTONE AND MISOPROSTOL VERSUS MISOPROSTOL ALONE IN MID TRIMESTER TERMINATION OF PREGNANCY

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    Surendra Nath Soren

    2018-01-01

    Full Text Available BACKGROUND Termination of pregnancy in second trimester continues to be a challenge in developing countries especially in rural areas. There is an exponential rise in complications of abortion along with advancing gestational age. The search is on for an ideal method of abortion, which is reliable, safe and cheap. This study was conducted in M.K.C.G. Medical College and Hospital, Berhampur, from November 2015 to October 2017 with the aim of finding an effective method to induce second trimester abortion within reasonable time with fewer complications. MATERIALS AND METHODS A total of 80 patients were studied to compare combination of mifepristone and misoprostol (30 patients with single drug misoprostol alone (50 patients for second trimester abortion. The Induction Abortion Interval (IAI, success rate, misoprostol dose requirement and side effects with demographic characteristics were compared between the two groups. RESULTS There was a significant difference in the IAI in both the groups. The mean IAI was 562.218 minutes in study group, whereas in control group, IAI was 922.698 minutes. The success rate (complete abortion was 92.5% in study group and 68.4% in control group, and this was statistically significant. Misoprostol dose requirement (average in study group was 1081.48 μg and in control group was 1675.67 μg. More side effects were observed in the control group. CONCLUSION Mifepristone followed by misoprostol was more effective than misoprostol alone as it had a shorter IAI, better success rate, less requirement of misoprostol and fewer side effects.

  3. Cost-effectiveness analysis of alternative first-trimester pregnancy termination strategies in Mexico City.

    Science.gov (United States)

    Hu, D; Grossman, D; Levin, C; Blanchard, K; Goldie, S J

    2009-05-01

    To assess the comparative health and economic outcomes associated with three alternative first-trimester abortion techniques in Mexico City and to examine the policy implications of increasing access to safe abortion modalities within a restrictive setting. Cost-effectiveness analysis. Mexico City. Reproductive-aged women with unintended pregnancy seeking first-trimester abortion. Synthesising the best available data, a computer-based model simulates induced abortion and its potential complications and is used to assess the cost-effectiveness of alternative safe modalities for first-trimester pregnancy termination: (1) hospital-based dilatation and curettage (D&C), (2) hospital-based manual vacuum aspiration (MVA), (3) clinic-based MVA and (4) medical abortion using vaginal misoprostol. Number of complications, lifetime costs, life expectancy, quality-adjusted life expectancy. In comparison to the magnitude of health gains associated with all safe abortion modalities, the relative differences between strategies were more pronounced in terms of their economic costs. Assuming all options were equally available, clinic-based MVA was the least costly and most effective. Medical abortion with misoprostol provided comparable benefits to D&C, but cost substantially less. Enhanced access to safe abortion was always more influential than shifting between safe abortion modalities. This study demonstrates that the provision of safe abortion is cost-effective and will result in reduced complications, decreased mortality and substantial cost savings compared with unsafe abortion. In Mexico City, shifting from a practice of hospital-based D&C to clinic-based MVA and enhancing access to medical abortion will have the best chance to minimise abortion-related morbidity and mortality.

  4. Umbilical cord cysts in the first trimester: are they associated with pregnancy complications?

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    Hannaford, Karen; Reeves, Shane; Wegner, Elisabeth

    2013-05-01

    To determine whether umbilical cord cysts found by transvaginal sonography in the first trimester of pregnancy are associated with poor pregnancy outcomes. We conducted a matched cohort study between July 2006 and July 2008. Patients with umbilical cord cysts found on transvaginal sonography in the first trimester were matched to patients with normal umbilical cords. After the completion of these pregnancies, medical histories and pregnancy outcomes were reviewed from the hospital's electronic record. Sonograms were reviewed to obtain descriptive information about the umbilical cord cysts. Outcomes between the cohorts were compared. Forty-five patients with umbilical cord cysts were identified and compared to 85 patients with normal umbilical cords. The mean gestational age of the cysts ± SD at diagnosis was 8 weeks 3 days ± 3.5 days. The mean cyst diameter was 3 ± 2.1 mm. All cysts resolved on follow-up sonography, which was performed between 9 weeks 4 days and 20 weeks 5 days. Patients with umbilical cord cysts were found to have a lower body mass index than those with normal umbilical cords. There was no significant difference in abnormal sonographic findings between cohorts. Five sonographic fetal abnormalities were found in the umbilical cord cyst cohort (11.1%) and 8 in the normal umbilical cord cohort (9.4%). There were 2 intrauterine fetal demises in the umbilical cord cyst cohort and 1 in the normal umbilical cord cohort. There was no difference between the cohorts when comparing gestational age at delivery and birth weight. There does not appear to be an association between poor pregnancy outcomes and umbilical cord cysts during the first trimester.

  5. Proteomic Analysis of Early Mid-Trimester Amniotic Fluid Does Not Predict Spontaneous Preterm Delivery.

    Science.gov (United States)

    Hallingström, Maria; Lenco, Juraj; Vajrychova, Marie; Link, Marek; Tambor, Vojtech; Liman, Victor; Bullarbo, Maria; Nilsson, Staffan; Tsiartas, Panagiotis; Cobo, Teresa; Kacerovsky, Marian; Jacobsson, Bo

    2016-01-01

    The aim of this study was to identify early proteomic biomarkers of spontaneous preterm delivery (PTD) in mid-trimester amniotic fluid from asymptomatic women. This is a case-cohort study. Amniotic fluid from mid-trimester genetic amniocentesis (14-19 weeks of gestation) was collected from 2008 to 2011. The analysis was conducted in 24 healthy women with subsequent spontaneous PTD (cases) and 40 randomly selected healthy women delivering at term (controls). An exploratory phase with proteomics analysis of pooled samples was followed by a verification phase with ELISA of individual case and control samples. The median (interquartile range (IQR: 25th; 75th percentiles) gestational age at delivery was 35+5 (33+6-36+6) weeks in women with spontaneous PTD and 40+0 (39+1-40+5) weeks in women who delivered at term. In the exploratory phase, the most pronounced differences were found in C-reactive protein (CRP) levels, that were approximately two-fold higher in the pooled case samples than in the pooled control samples. However, we could not verify these differences with ELISA. The median (25th; 75th IQR) CRP level was 95.2 ng/mL (64.3; 163.5) in women with spontaneous PTD and 86.0 ng/mL (51.2; 145.8) in women delivering at term (p = 0.37; t-test). Proteomic analysis with mass spectrometry of mid-trimester amniotic fluid suggests CRP as a potential marker of spontaneous preterm delivery, but this prognostic potential was not verified with ELISA.

  6. Proteomic Analysis of Early Mid-Trimester Amniotic Fluid Does Not Predict Spontaneous Preterm Delivery.

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    Maria Hallingström

    Full Text Available The aim of this study was to identify early proteomic biomarkers of spontaneous preterm delivery (PTD in mid-trimester amniotic fluid from asymptomatic women.This is a case-cohort study. Amniotic fluid from mid-trimester genetic amniocentesis (14-19 weeks of gestation was collected from 2008 to 2011. The analysis was conducted in 24 healthy women with subsequent spontaneous PTD (cases and 40 randomly selected healthy women delivering at term (controls. An exploratory phase with proteomics analysis of pooled samples was followed by a verification phase with ELISA of individual case and control samples.The median (interquartile range (IQR: 25th; 75th percentiles gestational age at delivery was 35+5 (33+6-36+6 weeks in women with spontaneous PTD and 40+0 (39+1-40+5 weeks in women who delivered at term. In the exploratory phase, the most pronounced differences were found in C-reactive protein (CRP levels, that were approximately two-fold higher in the pooled case samples than in the pooled control samples. However, we could not verify these differences with ELISA. The median (25th; 75th IQR CRP level was 95.2 ng/mL (64.3; 163.5 in women with spontaneous PTD and 86.0 ng/mL (51.2; 145.8 in women delivering at term (p = 0.37; t-test.Proteomic analysis with mass spectrometry of mid-trimester amniotic fluid suggests CRP as a potential marker of spontaneous preterm delivery, but this prognostic potential was not verified with ELISA.

  7. Women's experiences with doula support during first-trimester surgical abortion: a qualitative study.

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    Chor, Julie; Lyman, Phoebe; Tusken, Megan; Patel, Ashlesha; Gilliam, Melissa

    2016-03-01

    To explore how doula support influences women's experiences with first-trimester surgical abortion. We conducted semistructured interviews with women given the option to receive doula support during first-trimester surgical abortion in a clinic that uses local anesthesia and does not routinely allow support people to be present during procedures. Dimensions explored included (a) reasons women did or did not choose doula support; (b) key aspects of the doula interaction; and (c) future directions for doula support in abortion care. Interviews were transcribed, and computer-assisted content analysis was performed; salient themes are presented. Thirty women were interviewed: 19 received and 11 did not receive doula support. Reasons to accept doula support included (a) wanting companionship during the procedure and (b) being concerned about the procedure. Reasons to decline doula support included (a) a sense of stoicism and desiring privacy or (b) not wanting to add emotion to this event. Women who received doula support universally reported positive experiences with the verbal and physical techniques used by doulas during the procedure, and most women who declined doula support subsequently regretted not having a doula. Many women endorsed additional roles for doulas in abortion care, including addressing informational and emotional needs before and after the procedure. Women receiving first-trimester surgical abortion in this setting value doula support at the time of the procedure. This intervention has the potential to be further developed to help women address pre- and postabortion informational and emotional needs. In a setting that does not allow family or friends to be present during the abortion procedure, women highly valued the presence of trained abortion doulas. This study speaks to the importance of providing support to women during abortion care. Developing a volunteer doula service is one approach to addressing this need, especially in clinics that

  8. Trimester-specific reference interval for thyroid hormones during pregnancy at a Tertiary Care Hospital in Haryana, India

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    Rajesh Rajput

    2016-01-01

    Full Text Available Background: Reference intervals for thyroid hormone during pregnancy need to be gestational age, method , and population specific and there is need to establish trimester-specific thyroid levels for the different population across the world. The aim of this study was to establish trimester-specific reference range for thyroid hormone during pregnancy in a tertiary care center in Haryana. Materials and Methods: A total of 1430 pregnant women were recruited for the study. Participants having any history of chronic illness, goiter on physical examination, thyroid illness in the past or present, consuming thyroid medications, family history of thyroid illness, presence of anti-thyroid peroxidase antibody, poor obstetrics history were excluded from the study and reference population was identified to calculate serum free triiodothyronine (FT3, free thyroxine (FT4 and thyrotropin (TSH for each trimester of pregnancy. Results: The 2.5–97.5th percentiles for FT3, FT4, and TSH obtained in this study were 2.53–4.54 pg/ml, 0.88–1.78 ng/ml and 0.37–3.69 μIU/ml in the first trimester, 2.0–4.73 pg/ml, 0.91–1.78 ng/ml and 0.54–4.47 μIU/ml in the second trimester, 2.01–4.01 pg/ml, 0.83–1.73 ng/ml, and 0.70–4.64 μIU/ml in the third trimester of pregnancy. Mean TSH increased and mean FT3 decreased significantly with the progression of gestational period. FT4 decreased from trimester 1–3rd, but the decrease was nonsignificant from 2nd to 3rd trimester. Conclusions: Existing results for trimester-specific reference intervals for thyroid hormones are inconsistent and cannot be extrapolated due to differences in ethnicity, maternal iodine status, laboratory assay method, and rigor for selection of reference population. Thus, establishment of reference intervals in each region is of great importance.

  9. Spontaneous first trimester miscarriage rates per woman among parous women with 1 or more pregnancies of 24 weeks or more.

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    Cohain, Judy Slome; Buxbaum, Rina E; Mankuta, David

    2017-12-22

    The purpose of this study was to quantify spontaneous first trimester miscarriage rates per woman among parous women. A vast amount of data has accumulated regarding miscarriage rates per recognized pregnancy as well as about recurrent miscarriage. This is the second study of miscarriage rates per woman in a parous population and the first study of recurrent and non-recurrent, spontaneous first trimester miscarriage rates per woman in a large parous population. Extraction of the following variables from all delivery room admissions from both Hadassah Medical Centers in Jerusalem Israel, 2004-2014: # of first trimester spontaneous miscarriages, # live births; # living children; age on admission, pre-pregnancy height and weight, any smoking this pregnancy, any alcohol or drug abuse this pregnancy, blood type, history of ectopic pregnancy, history of cesarean surgery (CS) and use of any fertility treatment(s). Among 53,479 different women admitted to labor and delivery ward, 43% of women reported having had 1 or more first trimester spontaneous miscarriages; 27% reported having had one, 10% two, 4% three, 1.3% four, 0.6% five and 0.05% reported having 6-16 spontaneous first trimester miscarriages. 18.5% had one or more first trimester miscarriages before their first live birth. Eighty-one percent of women with 11 or more living children experienced one or more first trimester miscarriages. First trimester miscarriage rates rose with increasing age, increasing parity, after previous ectopic pregnancy, after previous cesarean surgery, with any smoking during pregnancy and pre-pregnancy BMI ≥30. Miscarriages are common among parous women; 43% of parous women report having experienced one or more first trimester spontaneous miscarriages, rising to 81% among women with 11 or more living children. One in every 17 parous women have three or more miscarriages. Depending on her health, nutrition and lifestyle choices, even a 39 year old parous woman with a history of 3 or

  10. Umbilical hypercoiling in 2nd- and 3rd-trimester intrauterine fetal death.

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    Dutman, Annemiek C; Nikkels, Peter G J

    2015-01-01

    Cases of unexplained intrauterine fetal death (IUFD) can be reduced by full placental examination, with or without autopsy. Determination of the umbilical coiling index (UCI) is considered to be a part of full placental examination. Umbilical hypercoiling (UCI above 0.30 coils/cm) is associated with IUFD. In a large retrospective study, we found an incidence of 18% umbilical hypercoiling in IUFD. We explored the association between umbilical hypercoiling and 2nd- and 3rd-trimester IUFD in 77 cases. There was a significant negative correlation between the UCI and gestational age of IUFD (PUCI should be part of the routine placental examination of cases of IUFD.

  11. Three-dimensional colour Doppler of ductus venous agenesis in the first trimester

    OpenAIRE

    Divya Singh; Ladbans Kaur

    2016-01-01

    Ductus venosus (DV) has a pivotal role in the fetal circulation. It serves as a conduit connecting the fetal umbilical and portal venous system with the inferior vena cava (IVC). The absence of DV is an uncommon anomaly. In case of agenesis of DV, the umbilical vein joins the fetal systemic venous circulation via the intra-hepatic or extra-hepatic route. We report a case of absent DV with associated anomaly diagnosed in the first trimester using three-dimensional (3D) colour Doppler.

  12. Three-dimensional colour Doppler of ductus venous agenesis in the first trimester

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    Divya Singh

    2016-11-01

    Full Text Available Ductus venosus (DV has a pivotal role in the fetal circulation. It serves as a conduit connecting the fetal umbilical and portal venous system with the inferior vena cava (IVC. The absence of DV is an uncommon anomaly. In case of agenesis of DV, the umbilical vein joins the fetal systemic venous circulation via the intra-hepatic or extra-hepatic route. We report a case of absent DV with associated anomaly diagnosed in the first trimester using three-dimensional (3D colour Doppler.

  13. Adiposity and hyperleptinemia during the first trimester among pregnant women with preeclampsia

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    Yeboah FA

    2017-06-01

    Full Text Available Francis Agyemang Yeboah,1 Robert Amadu Ngala,1 Ahmed Tijani Bawah,2 Henry Asare-Anane,3 Huseini Alidu,2 Abdul-Wahab Mawuko Hamid,2 Joshua Dokurugu Kwame Wumbee4 1Department of Molecular Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, 2Department of Medical Laboratory Science, University of Health and Allied Sciences, Ho, 3Department of Chemical Pathology, School of Biomedical and Allied Health Sciences, University of Ghana, Accra, 4Internal Quality Control Unit, Quality Control Directorate, Kumasi Technical University, Kumasi, Ghana Background: Leptin levels start increasing from the early stages of pregnancy, irrespective of the maternal body mass index. Leptin levels are increased in pregnant women with preeclampsia (PE and may precede the clinical onset of the disease, with peaks occurring around 28 weeks of gestation. This study was aimed at determining whether serum leptin concentration and body fat percentage are significantly altered during the first trimester in pregnancies that subsequently develop PE and whether such changes are useful in predicting the disease.Materials and methods: This was a prospective longitudinal study conducted among pregnant women in Ho municipality. A cohort of 314 pregnant women was monitored from the first antenatal visit to delivery period at the Volta Regional Hospital, Ho, Ghana. Maternal serum leptin and lipid profile were analyzed and body fat percentage determined during first trimester. Body mass index was also calculated.Results: First trimester serum leptin level (P<0.0001 and body fat percentage (P<0.0001 were significantly higher in those who developed PE than those who did not; while triglycerides (P=0.8600, total cholesterol (P=0.5620, high-density lipoprotein (P=0.5880, low-density lipoprotein (P=0.4870 and very low-density lipoprotein (P=0.6540 did not show any significant difference between those with PE and those without PE.Conclusion: Leptin levels are increased

  14. Utility of ultrasound for evaluating the appendix during the second and third trimester of pregnancy.

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    Lehnert, Bruce E; Gross, Joel A; Linnau, Ken F; Moshiri, Mariam

    2012-08-01

    This study aims to retrospectively evaluate the right lower quadrant ultrasounds in women presenting during the second or third trimester of pregnancy for the frequency of appendix visualization and accuracy in diagnosing appendicitis. Institutional Review Board approval was obtained for this Health Insurance Portability and Accountability Act-compliant study. We reviewed imaging records from 99 consecutive pregnant women from 2001 to 2011 who presented during the second (≥14 weeks gestation) or third trimester for right lower quadrant ultrasound to evaluate the appendix. Visualization of the appendix as well as the size and compressibility, if identified, were recorded. The medical records and labs related to the initial patient presentation, subsequent management, and follow-up were reviewed for surgical and clinical outcomes. Pathology records were reviewed to determine if appendicitis was present when appendectomy was performed. Patients who underwent appendectomy were considered to have appendicitis based on pathology results, and patients managed non-operatively with symptom improvement and those with a normal appendix at pathology were considered to not have appendicitis. During the study period, 99 women meeting inclusion criteria presented to our institution for right lower quadrant ultrasound to evaluate the appendix during the second or third trimester of pregnancy. The mean gestational age at presentation was 23 weeks (±7 weeks). The mean maternal age was 28 years (±6.6 years). The appendix was not visualized in 97% (96/99) of right lower quadrant ultrasound examinations. Of the three studies in which the appendix was visualized, two were considered positive for appendicitis and one was considered negative. Eight patients in this group ultimately underwent appendectomy, including the two patients with positive right lower quadrant ultrasounds, and appendicitis confirmed at pathology in seven of these cases (87.5%). Right lower quadrant ultrasound

  15. [Adnexal torsion and concominant appendicitis during third trimester of pregnancy--a case report].

    Science.gov (United States)

    Markova, D; Milchev, N; Gurova, A; Batashki, I

    2009-01-01

    Adnexial torsion is a rare, but important cause for abdominal pain during pregnancy. During pregnancy, its frequency is 10-20%, with highest frequency in the first trimester. We present a case of 24 year primigravida, with an acute onset of clinical symptoms with concominant disease chronic pyelonephritis. The initial diagnosis was exacerbation of the concominant disease and acute inflammation of the appendix. The intraoperative diagnosis was right adnexial torsion and inflammation of the appendix; the diagnosis was pathologically proved. Although rare, it can be included in the differential diagnosis of acute abdomen during pregnancy.

  16. Non-postural serial changes in renal function during the third trimester of normal human pregnancy.

    Science.gov (United States)

    Ezimokhai, M; Davison, J M; Philips, P R; Dunlop, W

    1981-05-01

    Seventeen healthy women were investigated near the beginning and again near the end of the third trimester of their normal pregnancies. Infusion studies were performed in the left lateral position. There was a highly significant decrease in effective renal plasma flow but not in glomerular filtration rate, measured as inulin clearance. Plasma creatinine concentration increased significantly, but the renal handling of creatinine was unchanged; simultaneous 24-hour creatinine clearance showed a tendency to decrease. Serum urate concentration also increased significantly, apparently due to an increase in net tubular reabsorption of urate.

  17. Total and Trimester-Specific Gestational Weight Gain and Offspring Birth and Early Childhood Weight

    DEFF Research Database (Denmark)

    Scheers Andersson, Elina; Silventoinen, Karri; Tynelius, Per

    2016-01-01

    Gestational weight gain (GWG) has in numerous studies been associated with offspring birth weight (BW) and childhood weight. However, these associations might be explained by genetic confounding as offspring inherit their mother's genetic potential to gain weight. Furthermore, little is known about...... statistically weak, suggested no associations between GWG and offspring weight or BMI during infancy or childhood. Our study suggests that total, and possibly also second and third trimester, GWG are associated with offspring BW when taking shared genetic and environmental factors within twin pairs into account...

  18. Prevention of breast pain and milk secretion with bromocriptine after second-trimester abortion

    DEFF Research Database (Denmark)

    Nyboe Andersen, A; Damm, P; Tabor, A

    1990-01-01

    Within 24 hours after abortion, 62 patients with a mean gestational age of 19 weeks, who had either induced (n = 50) or spontaneous (n = 12) abortions were randomly allocated to three groups: Group 1, bromocriptine 2.5 mg twice daily for 2 weeks; Group 2, placebo tablets 1 tablet twice daily for 2.......01), in serum prolactin (PRL) (p less than 0.001) and in the subjective assessment score of breast pain (p less than 0.01) and milk secretion (p less than 0.01). Alleviation of breast pain and prevention of milk secretion appears to be indicated after second-trimester abortion, and treatment with bromocriptine...

  19. The rationale for third trimester testing of vertical HIV transmission in neonates with CMV infection.

    Science.gov (United States)

    Boos, Vinzenz; Feiterna-Sperling, Cornelia; Sarpong, Akosua; Garten, Lars; Cremer, Malte; von Weizsäcker, Katharina; Bührer, Christoph; Dame, Christof

    2016-08-01

    We report on a late-preterm neonate with severe congenital cytomegalovirus (CMV) infection, refractory to antiviral therapy with ganciclovir. Subsequent immune diagnostics led to the finding of HIV infection at day 69, even though the mother tested negative for HIV in early pregnancy. Thus, in congenital CMV infection, HIV testing should be performed to elucidate maternal HIV seroconversion during late pregnancy. Our case strongly supports third trimester screening of HIV infection acquired during pregnancy, yet recommended only for women with traditional risk factors for HIV or living in an area of high HIV prevalence.

  20. Central pontine myelinolysis presenting as isolated sixth nerve palsy in third trimester of pregnancy.

    Science.gov (United States)

    Gosavi, Tushar Divakar; See, Siew Ju

    2015-01-01

    A 30-year-old primigravida presented with isolated left sixth nerve palsy at 38 weeks gestation. Her MRI showed a lesion consistent with central pontine myelinolysis (CPM). Extensive investigations did not reveal any secondary cause for the CPM. She recovered spontaneously in 2 weeks with complete resolution of her MRI changes. To our knowledge, this is the first report of CPM occurring in third trimester in the absence of identifiable secondary causes and of CPM presenting as an isolated sixth nerve palsy. We discuss the reported causes of CPM in pregnancy, possible pathophysiologic mechanisms involved and the anatomic basis of the unique clinical presentation of sixth nerve palsy in our case.