Summary. The aetiological role of Chlamydia trachomatis (CT) and herpes simplex virus (HSV) was investigated in 189 patients with threatened abortion. Assessment of infection was based on isolation, and on determination of serum immunoglobulin (Ig)G and IgA antibodies as well as cervical IgA antibody levels with new sensitive radioimmunoassay (RIA) techniques. One third of the women were delivered of a healthy infant and two thirds aborted, but the two groups were otherwise clinically similar. By isolation, only 2.7% of the patients were CT‐positive, but increased cervical IgA antibody level to CT was detected in 41.3%. The mean level of these local antibodies was similar in both study groups, but the mean levels of serum IgA and IgG antibodies were somewhat higher in the patients who aborted although the difference was not significant. None of the cervical specimens was positive for HSV by isolation but the cervical IgA antibody level to HSV was raised in 47.1% of the patients. Both cervical and serum IgA antibody levels to HSV were significantly raised among the patients who aborted, but there were no differences between the patients with spontaneous abortion and those with a blighted ovum. There was no clear association between CT and abortion, but an association between HSV and abortion is possible. The incidence of raised levels of both CT and HSV IgA antibodies in the cervix was surprisingly high in both groups and the significance of this finding remains to be investigated.
The fetal loss rates and fetal congenital birth defects in 821 transabdominal (TA) chorionic villus sampling (CVS) and 771 amniocentesis (AC) cases were evaluated from a 5-year period (1987-1991) at the University Central Hospital of Turku. The parents were given the option of choosing between the two sampling procedures. CVS was performed, in most cases, at 11 weeks of gestation; and AC, at 15 weeks. The rate of total post-procedure loss was 6.7 per cent in the CVS group and 4.4 per cent in the AC group (p = 0.08). The rate of spontaneous abortions was 1.9 per cent in the CVS group and 1.0 per cent in the AC group (p = 0.10). The number of birth defects was low in both study groups. No limb reduction cases were observed. Mosaicism was noted in 14 CVS cases and in five AC cases. We conclude that TA-CVS is a safe and practical alternative to AC in prenatal fetal karyotyping.
Summary The association of Chlamydia trachomatis (CT) and herpes simplex virus (HSV) with malignant or premalignant changes in the cervix uteri was studied by determining immunoglobulin A (IgA) antibodies in the cervical secretions of 28 women with inflammatory, 28 with dysplastic, 7 with malignant changes of the uterine cervix, and 26 healthy controls. In cervical secretions IgA antibodies to CT were found in 24 of 35 (69%) patients with malignant or premalignant changes, in 11 of 28 (39%) with cervicitis and in 3 of 26 (12%) controls. IgA antibodies to HSV were found in 10 of 35 (28%) patients with malignant atypia or dysplasia but in none of the women with cervicitis or the controls. The highest frequency of antibodies was found in the patients with cervical carcinoma. Serum IgA antibodies to CT and HSV were found equally in the patients and the controls. Our results suggest that in patients with cervical atypia, local IgA CT antibody production occurs. Whether this association is aetiological or coincidental can not be concluded from this study.
Antibacterial activity and trace element concentrations in amniotic fluid (AF) were determined in a population of 39 pregnant women in the second half of gestation. Antibacterial activity in each AF was measured by a spectrophotometric micromethod after 18 h incubation at 37 °C using Escherichia coli K 12 as a reference bacterium. Concentrations of zinc, iron, copper, calcium, potassium and bromine were measured by particle-induced X-ray emission method and the zinc concentration was also measured by atomic absorption spectrophotometry. Phosphate concentration was determined by direct albumin adding method. In AFs with good antibacterial activity significantly lower concentrations of potassium and bromine were found when compared to AFs with lower antibacterial activity. Concentrations of zinc, iron, copper, calcium or phosphate did not correlate with antibacterial activity in AF.
A new method for assessing antibacterial activity in amniotic fluid (AF) is presented. Sample sizes of 100 microliter were incubated at 37 degrees C in an equal amount of growth medium with inoculated bacteria. The quantification of bacterial growth was established by measuring the change in optical density with an automated spectrophotometer. In this study, Escherichia coli, type K 12, was used for inoculation and the bacterial growth was assessed after 6, 18, 30, 42, and 54 hours' incubation. The variation coefficients in intra-assay and interassay measurements were 3.8 and 5.2%, respectively. Shaking of the incubated sample significantly changed the results by increasing the number of viable cells in the most probable number method and decreasing the optical density difference in the spectrophotometric method. Nevertheless, the correlation between the results in both methods was good (r = 0.94, p less than 0.05, and r = 0.98, p less than 0.01, respectively). By filtering the AF sample before incubation, a great deal of antibacterial activity was removed. The reproducibility, simplicity, and rapidity of this spectrophotometric method of assessing antibacterial activity in AF may make it a useful clinical tool.
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