In Cuba and in the German Democratic Republic (GDR) a total of 24,412 pregnant women were tested for maternal serum alpha-fetoprotein (MSAFP) at the 16th to 20th week of gestation. An inexpensive and partly automated ultramicroliter enzyme immunoassay (ELISA) with final volumes of 10 microliter was used to analyze simultaneously 50 samples. The intraassay coefficient of variation (CV) of 5-8% and day/day CVs of 6-10.5% were obtained with a test frequency of 320 assays/day. A cut-off level of twice the median value (MoM) was chosen. An amniocentesis was done in a total of 0.5% (in the GDR) and 0.7% (in Cuba) of the screened women. The prevalence of open neural tube defects (ONTD) was calculated from the present study and was 1.43% in Cuba and 1.34% in the GDR. Through MSAFP screening 88.2% ONTD were detected. There was no therapeutic abortion of a normal fetus. The approximate cost for this program was about 2.36 marks-GDR per patient screened, or about 2,048 marks per ONTD detected.
Amniofetography represents an adequate method to study prenatally the fetal gastrointestinal tract in utero. In 108 pregnancies without fetal intestinal anomalies, the course of intestinal growth with regard to the lumen of certain parts of intestine has been analyzed. The results agree with those of other authors using sonography to study the intrauterine development of fetal intestinal tract. The demonstrated kinetics of contrast media passage through the gastrointestinal tract, following its intra-amnion application, contribute the knowledge of normal fetal physiology.
In a twin pregnancy of a 25-year-old woman one fetus was a normal male, while the other had hydrocephalus (6 mm thick pallium in the 23rd week) and a neural-tube defect in the thoracic-lumbar region. The abnormal fetus was removed by minor section in the 24th week, after which the normal one developed without complication. A healthy boy, weighing 3050 g and 52 cm long, was delivered spontaneously in the 39th week. Palpation of the uterus revealed a dehiscence, covered by muscle, in the region of the uterotomy scar, but it required no revision.
Ultrasonographic observations of the development of the hydrocephalic lateral ventricles during the fetal period. Twenty-three pregnant women having a fetus with brain defects were followed up. Twenty had sonographically identified hydrocephalus and 3 others had a fetus with either porencephalia, cystencephalus or monstrous defect of the brain. The use of a ventricular model (see 1st communication) permitted an observation of the development of the volume of the lateral ventricles, the brain diameter and an estimation of the prognosis. Accompanying defects (e.g. spina bifida in 56% of cases) were noted. Detailed case studies, measurements, clinical observation of the course, combinations of defects, and special diagnostic measures were compared with postpartum conditions.
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