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Prenatal diagnosis, treatment and outcomes of fetal bronchopulmonary sequestration-analysis of 68 cases

Gang YU ; Chun HONG ; Xiaoyan MA ; Limin WANG

Chinese Journal of Perinatal Medicine.2013;16(9):537-542. doi:10.3760/cma.j.issn.1007-9408.2013.09.009

Objective To review and analyze the prenatal diagnosis and treatment of fetal bronchopulmonary sequestration (BPS).Methods Data of 68 BPS fetuses in the Department of Fetal Medicine,Guangdong Women and Children Hospital and Health Institute from January 20,2009 to January 31,2013 were reviewed.All of the 68 fetuses were diagnosed by ultrasound and volume to head circumference ratio (CVR) was measured.Postnatal surgeries at neonatal or infantile period were performed and babies were followed-up.Results With antenatal ultrasonography,fetal chest solid or hyper-echoic mass was found in all 68 cases at an average of 24 weeks of gestation (18-30 weeks) and were diagnosed as BPS after at least twice ultrasound scans.CVR was measured in these 68 cases,among them 56 cases (82.4％) were ＜1.6,and 12 cases (17.6％) were ≥1.6.Among the 12 cases with CVR≥1.6,seven developed fetal hydrops.Except for two terminated pregnancies because of CVR≥ 1.6 with fetal hydrops,all of the rest 66 cases continued their pregnancies till birth and 58 (87.9％) neonates were asymptomatic and eight (12.1％) were symptomatic.The mass was undetectable with ultrasonography in 18 fetuses during the third trimester,however,the mass was identifed again under CT scan after birth in 14 cases (another four cases unexamined).There were totally 45 cases fully recovered after lobectomy or BPS resection after birth,among which five cases underwent emergency surgery in neonatal period.Pathology results showed that 12 cases were intra-lobar and 33 cases were extra-lobar type.Totally,six cases were diagnosed as BPS under diaphragm.Sixty cases were followed up at three months to two years after birth,and all developed well and CT scan indicated normal pulmonary function.Conclusions Most BPS fetuses without hydrops have a good outcome.Fetus with BPS could wait for full term delivery following professional evaluation and standard protocol.However,the prognosis of BPS with fetal hydrops depends on prenatal evaluation and early surgical intervention.And the effect of early surgical intervention in BPS neonates is satisfied.CVR is the most important index for prenatal evaluation of BPS and CT scan after birth is critical for those babies with undetectable mass by prenatal ultrasound.

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Placental expression of lipoprotein lipase and endothelial lipase in women with severe preeclampsia

Hong SHEN ; Weiwei CHENG ; Yifei CHEN ; Xiao WANG

Chinese Journal of Perinatal Medicine.2013;16(9):566-571. doi:10.3760/cma.j.issn.1007-9408.2013.09.015

Objective To investigate the effect of abnormal lipid metabolism in the pathogenesis of preeclampsia.Methods Thirty women with severe preeclampsia who delivered by cesarean section in the International Peace Maternity & Child Health Hospital from November 1,2011 to June 30,2012,were included as the study group.Thirty normal pregnant women delivered during the same period by cesarean section were included as the control group.The mRNA levels of lipoprotein lipase (LPL) and endothelial lipase (EL) in the placentas were quantified by real-time polymerase chain reaction.The expression of LPL/EL protein was detected by Western-blot assay and the distribution on the placenta was determined by immunohistochemical staining.The maternal serum level of lipid markers was detected by automatic biochemical analyzer.Difference between the two groups was compared with t-test or rank-sum test.Results (1) The triglyceride (TG) concentration [(3.35±0.80) mmol/L vs (2.75± 0.92) mmol/L,t =3.082,P=0.003] and atherosclerosis index (AI) (2.76±0.46 vs 2.47±0.34,t=3.066,P=0.003) increased in the study group compared with the control group,while the concentration of high-density lipoprotein-cholestrol (HDL-c) decreased[(1.64 ± 0.34) mmol/L vs (1.85 ± 0.22) mmol/L,t=-3.157,P =0.003].(2) The median level of LPL mRNA expression in placenta of the study group was higher than that of the control [1.26 (0.46-1.58) vs 0.52 (0.34-0.84),Z=-2.587,P=0.010],whereas the expression of EL mRNA was lower [0.65 (0.48-0.76) vs 1.32 (0.94-1.62),Z=-4.154,P=0.000].(3) Immunohistochemical analysis showed that the placenta EL and LPL located in cytoplasm of syncytiotrophoblast cells at the materno-placental interface and of endothelial cells at the feto-placental interface.(4) Compared with the control group,the median level of LPL protein expression in placenta inthe study group increased [0.68(0.46-0.83) vs 0.31(0.15-0.55),Z=3.335,P=0.001],and the expression of EL protein decreased [0.13 (0.11 0.16) vs 0.70(0.56 0.81),Z=-5.711,P=0.000].The expression of LPL protein was negatively correlated with that of EL protein (r=-0.501,P=0.000).Conclusions Abnormal lipid metabolism contributes to the pathogenesis of severe preeclampsia.

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Prevalence of macrosomia and its risk factors in China: a national survey in 2011

Guanghui LI ; Lijun KONG ; Zhiwen LI ; Li ZHANG ; Ling FAN ; Weiyuan ZHANG

Chinese Journal of Perinatal Medicine.2013;16(9):546-550. doi:10.3760/cma.j.issn.1007-9408.2013.09.011

Objective To investigate the prevalence of macrosomia in China and the risk factors.Methods By stratified cluster random sampling,the medical records of 101 723 singleton term infants born in 37 hospitals nation wide (in 14 provinces) from January 1,2011 to December 31,2011 were reviewed.Adjusted odd ratio (aOR) and 95％ confidence interval (CI) were used to describe the risk factors.Population attribute risk (PAR) was used to quantitatively describe the associations between risk factors and the prevalence of macrosomia.Results The general prevalence of macrosomia was 7.3％ (7403/101 723).The prevalence varied among provinces (4.1％ to 13.4 ％).Logistic regression analysis showed that macrosomia were positively associated with living in northern China (aOR =1.4,95 ％ CI:1.2 ～ 1.6,PAR =19.9 ％),maternal age ≥ 35 (aOR =1.1,95％ CI:0.9～1.3,PAR=8.7％),pre-pregnant BMI≥28 (aOR=3.6,95％ CI:2.9～4.5,PAR=15.1％),gravidity＞1 (aOR=1.2,95％ CI:1.1～1.4,PAR=10.8％),parity＞1 (aOR=1.8,95％ CI:1.5～ 2.1,PAR=10.1％),maternal height≥160 cm (aOR =1.6,95％ CI:1.4～ 1.9,PAR=29.5％),gestational weight gain (GWG) ≥16 kg (aOR=2.2,95％ CI:1.9～2.4,PAR=25.2％),gestational diabetes mellitus (aOR=1.2,95％ CI:1.0～ 1.3,PAR =3.2％),gestational weeks≥40(aOR=2.4,95％ CI:2.1～ 2.7,PAR=34.4％)and baby boy (aOR=l.6,95％ CI:1.4～1.8,PAR=25.4％).Maternal BMI,gestational week and GWG were most strongly associated with macrosomia.Conclusions The prevalence of macrosomia varied dramatically between different areas in China.Pre-pregnancy BMI,gestational week and GWG,as the main modifiable risk factors for macrosomia,need more attention from health care providers.

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Maternal serum markers for Down syndrome screening in second-trimester and its relations with adverse pregnant outcomes

Qian ZHOU ; Xiaoyu HU ; Yulin JIANG ; Xuming BIAN ; Juntao LIU

Chinese Journal of Perinatal Medicine.2013;16(9):555-560. doi:10.3760/cma.j.issn.1007-9408.2013.09.013

Objective To investigate the relationship between abnormalities of maternal serum markers in Down syndrome screening in second trimester and adverse pregnancy outcome.Methods Totally,1935 pregnant women were screened for Down syndrome with maternal serum tri marker with time-resolved fluorescence assay,including alpha fetoprotein (AFP),free β-human chorionic gonadotropin (β-hCG) and unconjugated estriol (uE3),between 15 and 20+6 gestational weeks at Peking Union Hospital from January 1,2009 to January 31,2011,and were followed up till delivery.The relationship between incidence of adverse pregnancy outcomes and women with normal or abnormal levels of serum markers in Down syndrome screening was investigated.T-test or Chi-square test were applied for statistical comparison.Results (1) Among the 1935 pregnant women,normal levels of serum markers were found in 1255(normal group) and 680 were abnormal(abnormal group),in which 577 with only one abnormal serum marker,89 with two and 14 with three abnormal serum markers.According to the serum marker level,the 577 women with one abnormal serum marker were further divided into five groups,including high AFP group (n=17),low AFP group (n=114),high β-hCG group (n=242),low β-hCG group (n=139) and low uE3 group (n=65).The birth weight of infants in lower AFP group and the gestational age at delivery in low β-hCG group were greater than those in normal group [(61.3±9.1) kg vs (59.5±8.3) kg,(272.6±11.8) d vs (274.4±10.1) d,t=2.21 and 1.99,both P＜0.01].(2) The incidence of adverse pregnancy outcome in normal group was 42.8％(537/1255),while comparing with the abnormal group(43.7％,297/680),no statistical significance was shown (RR =1.02,P =0.71).While comparing with the normal group,the incidences of placenta previa [25.5％ (32/1255) vs 2/17,RR=4.61,P＜0.05] and abnormal placental morphology were higher in high AFP group [4.1％ (51/1255) vs 5/17,RR=7.24,P＜ 0.05],the incidence of gestational diabetes mellitus (GDM) was higher in low AFP group [8.1％ (101/1255) vs 14.4％(16/114),RR=1.74,P＜0.05],the incidence of placenta and membrane retention was higher in high β-hCG group [3.5％ (44/1255) vs 6.2％(15/242),RR=1.77,P＜0.05],the incidence of pre-eclampsia was higher in low β-hCG group [1.7％ (21/1255) vs 6.5％ (9/ 139),RR=3.87,P＜0.05].(3) There were 89 women with two abnormal serum markers.Comparing with the normal group,the incidences of small for gestional age (SGA) infants,oligohydramnios,abruptio placenta were higher in women with low AFP but high β-hCG [SGA infants:6.9％(2/29) vs 1.8％(22/1255),RR=3.94; oligohydramnios:20.7％(6/29) vs 6.4％(80/ 1255),RR=3.24; both P＜0.05],the incidences of oligohydramnios was higher in women with both low AFP and low uE3[3/14 vs 6.4％(80/1255),RR=3.36,P＜0.05],the incidence of premature birth and GDM were higher in women with both low β-hCG and low uE3 [premature birth:2/6 vs 4.3％(54/1255),RR=7.75; GDM:3/6 vs 8.0％ (101/1255),RR=6.21; both P＜0.05].(4) There were 14 women with three abnormal serum markers.The relationship between adverse outcome and abnormal serum markers did not show any statistical significance.Conclusions The abnormality of serum markers of Down syndrome screening is closely related to adverse pregnancy outcomes,and women with abnormal serum markers should be carefully monitored during pregnancy.

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Impact of gestational weight gain and pre-pregnant body mass index on pregnant outcomes

Jin TONG ; Ning GU ; Jie LI ; Chenchen XU ; Lan YANG ; Zhenhua ZHU ; Zhiqun WANG

Chinese Journal of Perinatal Medicine.2013;16(9):561-565. doi:10.3760/cma.j.issn.1007-9408.2013.09.014

Objective To evaluate the effects of gestational weight gain(GWG) in different prepregnant body mass index (BMI) women on perinatal outcomes and to provide evidences for gestational weight management protocol.Methods Totally,2409 healthy singleton pregnant women accepted regular prenatal examinations in Nanjing Drum Tower Hospital from January 2009 to April 2010 were recruited in this study.They were divided into three groups according to pre-pregnant BMI,which were low BMI group (BMI＜18.5),normal BMI group (BMI 18.5-) and high BMI group (BMI≥24.0).According to GWG,the difference between pre-delivery maximal weight and prepregnant weight,the low and normal BMI women were divided into ＜10 kg,10 kg-and ≥15 kg GWG subgroups,and the high BMI women were divided into ＜5 kg,5 kg-,10 kg and ≥15 kg GWG subgroups.Data including gestational age,delivery modc,newborns' birth weight,Apgar score and incidences of gestational complications,such as hypertensive disorders complicating pregnancy (HDP),gestational diabetes mellitus (GDM),macrosomia,fetal growth restriction (FGR) and preterm birth,were recorded.Analysis of variance,Student-Newman Keuls,Chi-square test and Fisher exact test were applied for statistics.Results (1) Among the 2409 women,the percentages of low,normal and high BMI groups were 18.5％ (n=445),69.9％ (n=1685) and 11.6％ (n=279),respectively.The incidences of HDP,GDM,macrosomia and caesarean delivery in high BMI group were 12.9％ (n=36),17.9％ (n=50),13.6％ (n=38) and 52.3％ (n=146),respectively,higher than those in low BMI group [3.4％ (n=15),4.3 ％ (n=19),3.8％ (n=17) and 25.8％(n=115),x2 =23.8,37.1,23.5 and 50.2,P＜0.05] and those in normal BMI group [5.5％ (n=92),7.8％ (n=132),7.8％ (n=132)and 31.6％ (n=532),x2=21.8,29.0,10.1 and 3.4,P＜0.05].(2) In normal BMI group,the rates of FGR and preterm birth in GWG ＜10 kg subgroup were 3.5％ (4/115) and 8.7％ (10/115),higher than those in GWG 10 kg-subgroup [0.7％(4/548) and 3.3％(18/548),x2=6.0 and 6.9,P＜0.05] and GWG ≥15 kg subgroup [(0.8 ％ (8/1022) and 3.6％ (37/1022),x2=7.2 and 6.7,P＜0.05].The rates of macrosomia and cesarean delivery in GWG ≥15 kg subgroup were 10.7％ (109/1022) and 34.5％ (353/1022),higher than those in GWG＜10 kgsubgroup [3.5％ (4/115) and 32.2％ (37/115),x2=6.0 and 63.0,P＜0.05] and GWG 10 kg subgroup [3.5％ (19/548) and 25.9％ (142/548),x2=24.7 and 31.0,P＜0.05].(3) In high BMI group,the incidences of all pregnancy complications and perinatal outcomes did not show statistical significance among the four GWG subgroups (P＞0.05).Conclusions High prepregnant BMI is a high risk factor of pregnancy complications.It is suggested that normal BMI women should control GWG at 10-15 kg to lower the incidences of pregnancy complications.

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Protective mechanism of 1,25-Dihydroxyvitamin D3 on hyperoxia-induced lung injury in neonatal rats

Qiong LI ; Lin WANG ; Yan CHEN ; Yuan TIAN ; Li SHU ; Xue SUN

Chinese Journal of Perinatal Medicine.2013;16(10):585-588. doi:10.3760/cma.j.issn.1007-9408.2013.10.003

Objective To investigate the effects and mechanisms of 1,25-Dihydroxyvitamin D3 [1,25(OH)2 D3] on hyperoxia-induced lung injury of neonatal rats.Methods Neonatal Sprague-Dawley rats were randomly divided into air group,hyperoxia group and 1,25(OH)2D3 group within 12 hours after birth,eight in each group.Rats in air group were exposed to air,while those in hyperoxia and 1,25 (OH) 2 D3 group were exposed to hyperoxia (≥85 ％ oxygen concentration).Rats in 1,25(OH)2D3 group were injected with 1,25(OH)2D3 0.5 μg/(kg · d) intraperitoneally once a dayfor seven days,meanwhile the rats in the other two groups received 0.9 ％ saline in the same way.All rats were sacrificed on day 7.Lung tissue sections were HE stained in order to assess lung histological changes and lung radical alveolar count (RAC).The levels of tumor necrosis factor-α(TNF-α),interleukin(IL)-1β and IL-6 mRNA were measured by real time-polymerase chain reaction.Analysis of variance and LSD test were applied for statistics.Results Compared with the air group,the weight of rats in the hyperoxia group was significantly lower on day 7 [(8.48±1.34) g vs (12.51±0.47) g,t=8.05,P＜0.05],while the weight of rats in 1,25(OH)2D3 group [(10.29±1.00) g] was higher than that in the hyperoxia group (t=3.61,P＜0.05).Lung tissue structure was normal in the air group.In the hyperoxia group,inflammatory exudation was observed in pulmonary interstitial,the alveolar size was uneven,and the RAC was lower than that in the air group (5.6±0.1 vs 6.8±0.2,t=21.45,P＜0.05).The RAC in 1,25(OH)2D3 group (6.2±0.1) was significantly increased compared with that in the hyperoxia group (t=11.76,P＜0.05),but still lower than that in the air group (t=9.69,P＜0.05).The expressions of TNF-α,IL-1β and IL-6 mRNA in hyperoxia group (0.0348±0.0006,0.0269±0.0003 and 0.0368 ± 0.0006) were higher than those in the air group (0.0111±0.0007,0.0040±0.0003 and 0.0162 ±0.0007,t=56.54,111.12 and 49.26,P＜0.05,respectively).The expressions of TNF-α,IL-1β and IL-6 mRNA in the 1,25 (OH)2D3 group (0.0203±0.0009,0.0141±0.0004 and 0.0251±0.0009) were lower than those in the hyperoxia group (t=34.44,61.93 and 27.99,P＜0.05,respectively),but higher than those in the air group (t=22.10,49.19 and 21.27,P＜0.05,respectively).Conclusions 1,25(OH)2D3 could attenuate hyperoxia-induced lung injury by inhibiting the expression of inflammatory cytokines.

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In vitro effects of human umbilical cord mesenchymal stem cells on airway secretions of ventilator associated pneumonia in newborns

Xiaohong LIU ; Jie YANG ; Wenyu DENG ; Ruihua LUO ; Luning ZHAO ; Xuaner ZHENG ; Haoming YANG

Chinese Journal of Perinatal Medicine.2013;16(10):589-592. doi:10.3760/cma.j.issn.1007-9408.2013.10.004

Objective To explore the effect and its possible mechanism of human umbilical cord mesenchymal stem cells (hUCMSCs) on bacterial growth in bronchoalveolar lavage fluid (BALF) of newborns with ventilator associated pneumonia (VAP).Methods Newborns admitted to neonatal intensive care unit (NICU) in Guangdong Women and Children Hospital Affiliated to Guangzhou Medical University from June 1,2012 to December 31,2012 were reviewed.The inclusion criteria were:(1)Positive BALF culture results.(2) Requirement of mechanical ventilation with tracheal intubation.(3) Diagnosed as ventilator-associated pneumonia.Two pieces of BALF samples of newborn were collected and randornaly divided into experimental and control group.hUCMSCs were added into the experimental group,while the same volume of conditioned medium was added into the control group.Both groups were incubated for six hours in humidified CO2 incubator at 37 ℃,then,bacterial growth was assessed by colony forming unit (CFU) counts.Levels of the antimicrobial peptides (Cathelicidin/LL-37 and human HBD-2) were determined by enzyme-linked immunosorbent assay and Western blot.Paired t-test was used for statistical analysis.Results Among the culture results of 31 newborns,there were Klebsiella pneumoniae (6 cases,19.3％),Stenotrophomonas narrow food aeromonas (6 cases,19.3％),Hemolytic staphylococci (5 cases,16.1％),Escherichia coli (3 cases,9.7％),Bacterial meningitis septicemia Elizabeth Platinum (3 cases,9.7％),Acinetobacter baumannii (3 cases,9.7％),Pseudomonas putida (2 cases,6.4％),Pseudomonas aeruginosa (1 case,3.2％),Staphylococcus aureus (1 case,3.2％) and Enterobacter cloacae (1 ease,3.2％).The CFU counts in experimental group were much less than those in control group [(2.60±0.67) ×104] CFU/ml vs [(1.18±0.32) ×105] CFU/ml,(t=-20.19,P＜0.01).Levels of Cathelicidin/LL-37 and HBD-2 in experimental group were higher than those in control group [Cathelicidin/LL-37:(8.98 ± 3.22) ng/ml vs (3.18 ± 1.57) ng/ml,t =17.79,P ＜ 0.01 ;HBD-2:(379.87±11.74) pg/ml vs (39.89±2.86) pg/ml,t=37.62,P＜0.01].Conclusions hUCMSCs had antimicrobial effect on bacterial growth in BALFs from ventilator associated pneumonia possibly by the secretion of antimicrobial peptides (Cathelicidin/LL-37 and HBD-2).

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Apparent diffusion coefficient in quantitative analysis of brain injury in term neonates with hypoxic-ischemic encephalopathy

Bo ZHAO ; Xuening ZHANG ; Guoping XU ; Huawei MENG

Chinese Journal of Perinatal Medicine.2014;17(1):6-9. doi:10.3760/cma.j.issn.1007-9408.2014.01.002

Objective Applying diffusion weighted image (DWI) and apparent diffusion coefficient (ADC) to analyze brain injury caused by hypoxic-ischemic encephalopathy (HIE) in term neonates.Methods From June 1,2010 to January 5,2011,thirty-eight full term neonates with HIE were hospitalized in the Second Hospital of Tianjin Medical University.Those with nervous system diseases were excluded.The 38 cases were divided to mild HIE group (n=24) and moderate-to-severe HIE group (n=14).The control group included 10 normal full term neonates without history of asphyxia.All babies were scanned by magnetic resonance imaging (MRI).Spin echo-echo planar imaging sequence was used for DWI images.ADC values of nine regions (frontal lobe gray matter,frontal white matter,parietal gray matter,parietal white matter,corona radiata,caudate nucleus,putamen,posterior limb of the internal capsule and thalamus) were measured.MRI and DWI images were compared.ADC values were compared by analysis of variance and Student-Newman-Keuls test.Results ADC values of the nine indicated regions (frontal lobe gray matter,frontal white matter,parietal gray matter,parietal white matter,corona radiata,caudate nucleus,putamen,posterior limb of the internal capsule and thalamus) were (1.37±0.07),(1.81±0.12),(1.35±0.10),(1.84±0.09),(1.23±0.11),(1.28±0.09),(1.18±0.08),(1.05±0.07) and (1.15±0.08) ×10-3 mm2/s in control group,(1.28±0.11),(1.60±0.15),(1.27±0.09),(1.59±0.20),(1.19±0.15),(1.19±0.13),(1.11±0.09),(0.97±0.11) and (1.06±0.12) ×10-3 mm2/s in mild HIE group,and (1.18±0.14),(1.51±0.22),(1.19±0.09),(1.56±0.19),(1.03±0.16),(1.08±0.07),(1.02±0.07),(0.87±0.09) and (0.96±0.12) × 10-3 mm2/s in moderate-to-severe HIE group.ADC values among the three groups had statistical difference (F=3.89,3.21,4.05,3.30,3.28,3.27,4.12,4.75and 4.72,all P＜0.05).ADC values of frontal lobe gray matter,frontal white matter,parietal gray matter,parietal white matter,putamen,posterior limb of the internal capsule and thalamus in mild HIE group were lower than those in control group (all P＜0.05).All of the ADC values of nine regions in moderate-to-severe HIE group were lower than those in control group (all P＜0.05).ADC value of frontal lobe gray matter,parietal gray matter,corona radiata,caudate nucleus,putamen,posterior limb of the internal capsule and thalamus in moderate-to-severe HIE group were lower than those in mild HIE group (all P＜0.05).Conclusion DWI and ADC values could reflect brain injury caused by HIE,and ADC values can be used to quantitatively analyze the degree of hypoxic-ischemic injury.

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Diagnosis of fetal chromosomal aneuploidy by free fetal DNA in maternal plasma in the first trimester

Ying CHANG ; Xu CHEN ; Hongyan CUI ; Chenchun REN

Chinese Journal of Perinatal Medicine.2014;17(1):14-18. doi:10.3760/cma.j.issn.1007-9408.2014.01.004

Objective To assess the clinical value of fetal chromosomal aneuploidy diagnosed by free fetal DNA in maternal plasma in 11-13+6 gestational weeks.Methods A total of 2 650 pregnant women who had prenatal care in Tianjin Center Hospital of Obstetrics and Gynecology from January 1,2010 to December 31,2010 were included.Each of them had an ultrasound scan to measure fetal nuchal translucency thickness.Maternal serum free β-human chorionic gonadotropin and pregnancy-associated plasma protein A test was performed as part of screening for chromosomal abnormalities.Results of ultrasound and maternal plasma biochemical analysis were entered into the database,and converted into multiple of median (MoM) by factors such as maternal age,weight,ethnicity,smoking history and mode of conception.The cutoff value was 1 ∶ 270.Meanwhile,20 cases had cell free fetal DNA (cffDNA) test and the ratio of the single nucleotide polymorphism on two alleles of plancenta-specific 4 (PLAC4) were measured in 16 cases.T-test,rank sum test,MannWhitney U test and Chi-square test were used as statistical methods.Results (1) A total of 74 cases were judged as high-risk,among which 35 cases underwent transabdominal chorionic villus sampling (18 cases had cffDNA test),37 cases underwent amniocentesis at the week of 20,and two cases of Rh negative did not receive the invasive examination.Totally 20 cases,including two Rh negative cases,had the cell-free fetal DNA test.(2) By cffDNA test of maternal plasma,two cases of 21 trisomy,one case of 18 trisomy,two cases of 45,XO and one case of balanced translocation were diagnosed.(3) In the two cases of 21 trisomy,maternal plasma G/A ratio ofPL4C4 RNA-single nucleotide polymorphism alleles was 1.00 (0.98,1.02) ; in 14 pregnancies with normal chromosome,the ratio was 1.055 (1.02,1.13,Z=3.5).There was no significant difference (P=0.066).Conclusion Diagnosing of fetal chromosomal aneuploidy by cffDNA in maternal plasma is feasible and noninvasive with high negative predictive value,and can be used in Rh-negative pregnant women for prenatal screening and diagnosis.

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Prenatal sonographic diagnosis of congenital vascular rings in eight fetuses

Dianmei LIU ; Junhua WANG ; Peifeng DAI ; Weiguang SHAO

Chinese Journal of Perinatal Medicine.2014;17(1):19-22. doi:10.3760/cma.j.issn.1007-9408.2014.01.005

Objective To explore the prenatal sonographic diagnosis of congenital vascular rings.Methods Eight fetuses with congenital vascular rings diagnosed in Affiliated Hospital of Weifang Medical College from January 9,2010 to November 25,2012 were retrospectively analyzed.All cases underwent threevessel trachea view to observe the position of aortic arch,its branches and the ductus arteriosus.The sonographic features were summarized.Results The eight cases were diagnosed at 22 to 28 gestional weeks,with an average of (25±2) weeks.They were 21 to 35 years old,with an average of (28±5) years.Seven cases were diagnosed by cardiac ultrasonography,and one induction case was diagnosed by autopsy.Among the eight cases,there were seven of right aortic arch with vagus left subclavian artery and left ductus arteriosus,and one case was complicated with double aortic arch.The former seven cases showed U-shape vascular ring surrounding the trachea composed of right aortic arch,vagus left subclavian artery and left ductus arteriosus.The other side of this U-shape was the heart structure,showing a complete vascular ring.In the latter one case,the O-shape vascular ring was composed of left and right sides of the aortic arch.Conclusion The U-shape,or O-shape vascular ring in three-vessel trachea view is the typical sonographic features of congenital vascular ring.Cardiac ultrasound examination should be performed on those suspected cases.

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