Prenatal Diagnosis of Congenital Rubella

Daffos, F.; Grangeot-Keros, L.; Lebon, Pierre; Forestier, F.; Pavlovský, Michal; Chartier, M.; Pillot, J.

doi:10.1016/s0140-6736(84)91993-7

Cited by 172 publications

(53 citation statements)

References 7 publications

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“…We have conducted 435 fetal blood samplings without accident by direct puncture of the umbilical cord under ultrasound. This procedure, already routinely used for prenatal diagnosis of hemophilia (31), rubella (32) and toxoplasmosis (33), could be applied to a wide range of new possibilities (34), including the study of the transplacental passage of drugs (35,36), the administration of intrauterine therapy (37), and possibly for fetal monitoring.…”

Section: Discussionmentioning

confidence: 99%

Hematological Values of 163 Normal Fetuses between 18 and 30 Weeks of Gestation

et al. 1986

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ABSTRACT. Utilizing an easy and safe ~rocedure for fetal MATERIALS AND METHODSblood sampling in utero we have studied 409 fetuses for prenatal diagnosis of rubella, toxoplasmosis, hemophilia, and hemoglobinopathies. Retrospectively we selected 163 fetuses confirmed as normal at birth and tested between 18 and 30 wk of gestation to establish normal hematological parameters and to follow the evolution of erythropoiesis, differential counts, hemoglobin synthesis, and hemostasis. Total white blood cell and platelet counts did not change during this period. Our knowledge of fetal hematology is limited due to the fact that most earlier studies were performed on aborted fetuses or under sampling conditions which may have altered hematological values. Moreover, only a few hematological values during gestation have been published (1). Having developed an easy and safe technique for fetal blood sampling, we selected retrospectively for this study 163 fetuses born healthy at full term delivery to establish reference fetal hematological values using standardized methods. To date no fetal loss or premature labor has been attributed to these fetal samplings.Sampling procedure. The fetal sampling method has been described in detail previously (2, 3). A real time ultrasound scanner (ATL MARK 111) was used to locate the umbilical cord insertion on the placenta and to determine the best route of access to it without fetal interposition. The transducer was then maintained immobile while, under aseptic conditions, local anesthesia was performed with 1 % xylocaine into the anterior abdominal wall at the chosen puncture site. No /3-mimetic drugs or other medication were used prior to the procedure. A 20-gauge spinal needle (10 or 13 cm long), filled with 0.129 M sodium citrate solution and fixed to a 2 ml disposable syringe containing 0.1 ml of this solution, was introduced into the plane of the ultrasound sector near the transducer. The needle tip emitted a clearly visible echo and its progress toward the insertion of the cord was followed on the scope. The vein of the cord was punctured about 1 cm from its insertion.Immediately after the first d r o~ of blood was obtained, the syringe was replaced by a new one containing no additive. The blood sample was immediately transferred into special tubes containing adequate anticoagulant for biological studies. The duration of the entire procedure was less than 10 min in 90% of the cases, and the automated evaluations of hematological parameters were completed within 30 min.Patients. We studied 409 pregnancies and 435 fetal blood samplings were camed out (26 repetitive samplings) with the approval of the ethics committee of the hospital, the medical expert panel, and the informed consent of the patients. The fetal samplings were conducted for the prenatal diagnosis of toxoplasmosis (285 cases), rubella (37 cases), or hemophilia (30 cases), for rapid fetal karyotyping (32 cases), or for diagnosis of other miscellaneous conditions (25 cases). Medical abortions of affected fetuses were perfor...

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Section: Discussionmentioning

confidence: 99%

Hematological Values of 163 Normal Fetuses between 18 and 30 Weeks of Gestation

et al. 1986

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“…This procedure was performed to determine whether rubella or toxoplasmosis infection occuning during pregnancy had contaminated the fetus. The ultrasoundguided technique and its results in the prenatal diagnosis of mother to fetus transmissible infection have been published previously ( 1,2,5). One and one-half to 3 ml of fetal blood were collected.…”

Section: Methodsmentioning

confidence: 99%

Serum Growth-Promoting Activity in Normal and Hypotrophic Fetuses at Midpregnancy

et al. 1987

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ABSTRACT'. Blood from 24 human fetuses aged 19-24 wk was collected by ultrasound-guided puncture of the umbilical cord in utero, performed for prenatal diagnosis of mother to fetus transmissible infections. Fetal serum growth-promoting activity (thymidine activity) was measured by its effect on 3H-thymidine incorporation into human lectin-activated lymphocytes. Ten blood samples were obtained at 19-22 wk of pregnancy and 14 at 23-24 wk. The pregnancies were maintained and the fetuses delivered, free of infection, at 38-40 wk, nine of them being small for date and 15 having a normal weight for gestation age. The bioassayable thymidine activity was significantly lower in the hypotrophic (0.84 2 0.04 U/ml) than in the normal fetuses (1.28 f 0.09 U/ml) whatever the time of sampling. Thymidine activity was significantly negatively correlated with gestational age in the normal for date fetuses, not in the small for date. It is suggested that early measurement of thymidine activity in fetal blood might be of value in the assessment of fetal growth despite the fact that the tissue growth factors may be more important in fetus than are the serum factors. (Pediatr Res 22: 39-40, 1987) Abbreviations Sm-C, serum somatomedin-C TA, thymidine activity IGF, insulin-like growth factor NFD, normal for date SFD, small for date SGA, small for gestation age Our understanding of the factors regulating fetal growth in humans and animals is quite limited. Fetuses that are SGA usually are discovered by ultrasonography after the 24th wk of pregnancy. The etiologic factors present before this time may include humoral growth-regulating factors acting during the 2nd trimester of pregnancy. To evaluate the growth-promoting activity of serum in normal living human fetuses aged less than 24 wk, we utilized two previously developed techniques: collection of fetal blood in utero for purpose of prenatal diagnosis (1, 2) and measurement of the stimulating effect of serum on the incorporation of tntiated thymidine into lectin-activated human lymphocytes (3, 4). Comparing the results in normal and hypotrophic fetuses was the aim of this study. MATERIALS AND METHODSFetal serum samples were obtained by direct puncture of the umbilical cord in utero. This procedure was performed to determine whether rubella or toxoplasmosis infection occuning during pregnancy had contaminated the fetus. The ultrasoundguided technique and its results in the prenatal diagnosis of mother to fetus transmissible infection have been published previously ( 1, 2, 5). One and one-half to 3 ml of fetal blood were collected. Contamination of fetal blood with maternal blood was assessed by screening red blood cell size by Coulter counter: any sample with significant maternal contamination was excluded. After clotting at room temperature, serum was decanted and stored at -80" C for later hormone evaluation.Satisfactory samples were collected from 24 fetuses at 19 to 24 wk of pregnancy which were proven not to have been contaminated. The fetal age was calculated from a) the 1st day...

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“…Since pregnancy is terminated after rubella because of the probability rather Improvements in the techniques of cordocentesis and IgM detection enabled four groups of workers to test fetal blood specimens from more than 60 cases of rubella during the first 4 months of pregnancy [73][74][75][76]. IgM was detected at 19-26 weeks in 17 cases and fetal infection was later confirmed in 15 of these by examining abortion material or specimens from the baby at term.…”

Section: Diagnosis Of Fetal Infectionmentioning

confidence: 99%

Laboratory diagnosis of rubella: past, present and future

Cradock-Watson

1991

Epidemiol. Infect.

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Fifty years ago in New South Wales the late Sir Norman Gregg [1] described congenital cataracts in 78 babies, 67 of whose mothers had had clinical rubella in early pregnancy; he concluded that the disease in the mother caused the abnormality in the baby. Gregg [1–3] and Swan [4, 5] and their colleagues reported that deafness, heart disease and microcephaly were also major components of the congenital rubella syndrome. The need to prevent this tragic outcome stimulated intensive work on laboratory diagnosis and vaccine development, leading to the isolation of rubella virus in 1962 and then to methods for antibody detection. These complementary advances established the two traditional pillars of virological diagnosis and opened the way to immunization, with the result that some countries are now on the verge of eliminating a disease which for over 100 years was regarded as no more than a mild and harmless exanthem of childhood.

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Prenatal Diagnosis of Congenital Rubella

Cited by 172 publications

References 7 publications

Hematological Values of 163 Normal Fetuses between 18 and 30 Weeks of Gestation

Hematological Values of 163 Normal Fetuses between 18 and 30 Weeks of Gestation

Serum Growth-Promoting Activity in Normal and Hypotrophic Fetuses at Midpregnancy

Laboratory diagnosis of rubella: past, present and future

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