A technique for sampling first trimester chorionic villi for prenatal diagnosis by transabdominal fine needle biopsy is described. Specimens of chorionic villi were obtained from 49 out of 58 women, a success rate of 84.5 per cent. No fetal or maternal complications were demonstrated in the period before abortion. The procedure is useful for obtaining fetal tissue for culturing, DNA analysis and direct chromosome analysis.
A consecutive series of 26 women followed to term after first trimester transabdominal chorionic villi sampling is presented. The clinical application of transabdominal chorionic villi sampling (TA-CVS) seems to have certain advantages, especially from the patients' point of view, but also in regard to successful sampling and to the complication ratio. The results in this clinical trial revealed no cases of abortions, no signs of placental damage and no cases of vaginal bleeding or infections.
To investigate the relationship of hemoglobin A1c (HbA1c) to average blood glucose concentration and to birth weight of infants of diabetic mothers, HbA1c was determined in 42 consecutive insulin-dependent pregnant diabetic women in the third trimester. HbA1c correlated significantly to the average blood glucose levels in the preceding 8 wk (r = 0.73, P less than 0.001). No correlation was found between HbA1c and the relative birth weight ratio (RBWR) for all newborn infants. However, in the major subgroups of pregnancies, White class B and C without prognostically bad signs in pregnancy (PBSP), HbA1c in the third trimester significantly correlated to RBWR (r = 0.59, P less than 0.01). In a subgroup of six pregnant diabetic women in whom HbA1c and blood glucose concentrations frequently were determined from the 13th to the 33rd gestational week, a relationship between HbA1c and the average blood glucose concentration of the preceding 8 and 12 wk in the individual pregnant subject was established. In spite of this correlation, HbA1c was found to be a poor predictor of the average blood glucose concentration in the individual patient. This indicates that HbA1c cannot satisfactorily describe the degree of diabetes control without simultaneous determinations of blood glucose. HbA1c determinations were found to be of value as an additional indicator of the quality of regulation during ambulatory control in diabetic pregnancy because an increase in HbA1c suggested an impairment of diabetic control. The perinatal mortality and morbidity of the infants of diabetic mothers were satisfactory in this series, as only one perinatal death, one nonserious malformation, and two cases of mild respiratory distress syndrome occurred among the 43 infants.
In three centers in Copenhagen prenatal chromosome analysis has been carried out on 93 fetuses. Forty patients had earlier born a child with Down's syndrome. One had a 47,XY,+D trisomy fetus. Twenty were 40 years of age or more. Two fetuses in this group had 47,XY,$21 trisomy and one patient had a spontaneous abortion, which was found to have the same constitution. In four of five pregnancies with familial translocations the fetus was a translocation heterozygote. In five cases with relatives affected with Down's syndrome, in seven where the mother had earlier born a child with a chromosome anomaly not being +21 trisomy and in seven a t risk of various inborn errors of metabolism, the fetuses were normal with regard to the chromosome constitution. Seven of nine cases, which were a t risk of having an X-linked disease, were males. Five of these were therepeutic aborted, one denied abortion and had an affected male child. One male fetus had a haemophilic father and the family did not want another carrier female.
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