Download Prenatal Medicine by John M. G. van Vugt, Lee P. Shulman PDF

By John M. G. van Vugt, Lee P. Shulman

On the state of the art of maternal and neonatal administration and examine, this reference provides the newest advances in fetal DNA/RNA, embryoscopy/fetoscopy, open fetal surgical procedure, and ethnic inhabitants screening to control pre-existing and newly detected maternal scientific problems, observe genetic and congenital abnormalities, hinder preterm births, and optimize being pregnant results. With illustrative colour pictures, this resource deals contributions by means of esteemed pros at revered associations all over the world and covers criminal concerns pertaining to prenatal overview and analysis.

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POTENTIAL FUTURE DEVELOPMENTS One new and exciting ultrasound marker of aneuploidy is the observation of an absent nasal bone at the 11- to 14-week scan. 5% of normal fetuses (99). The findings in this preliminary study were confirmed in other smaller studies (100). 8% of cases with a normal karyotype. However, there were some differences in incidence between different ethnic groups and a relationship between crown–rump length and NT (101). One way in which this marker may be used in the future is to incorporate it into the existing first-trimester scan as part of the combined ultrasound and biochemistry screening at 11–14 weeks.

First trimester screening for trisomy 21 in singleton pregnancies achieved by assisted reproduction. Hum Reprod 2001; 16:1501–1504. 76. Spencer K, Ong CYT, Liao AWJ, Nicolaides KH. The influence of ethnic origin on first trimester biochemical markers of chromosomal abnormalities. Prenat Diagn 2000; 20:491–494. 77. Watt HC, Wald NJ, Smith D, Kennard A, Densem J. Effect of allowing for ethnic group in prenatal screening for Down’s syndrome. Prenat Diagn 1996; 16:691–698. 78. Spencer K. The influence of smoking on maternal serum PAPP-A and free beta hCG levels in the first trimester of pregnancy.

For first trimester markers, there is very little evidence to support the need for correction. Levels of PAPP-A were shown to be reduced in IDDM mothers in one study (70) and in those with pre-existing or gestational diabetes free b-hCG was reduced by 20% and PAPP-A by 25% (71). In another smaller study (72), both free b-hCG and PAPP-A levels were 14% lower in women with gestational diabetes. If such reductions are confirmed in other studies, then it may be necessary to make correction in women with IDDM.

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