Résumé
PURPOSE: To assess the value of first-trimester pregnancy-associated plasma protein-A (PAPP-A), nuchal translucency (NT) and second-trimester alpha-fetoprotein (AFP), human chorionic gonadotropin (hCG), unconjugated estriol (uE3), and inhibin-A in predicting pregnancy complications other than fetal aneuploidy. MATERIALS AND METHODS: A retrospective study in 3,121 singleton pregnancies with integrated testing was performed at Kangnam CHA hospital between January 2005 and December 2006. Baseline characteristics, pregnancy outcomes, and serum marker levels were obtained by review of the medical records. We analyzed the data to identify associations between the integrated screening markers and adverse pregnancy outcomes. Statistical analyses were performed with the SPSS program. RESULTS: In preterm labor and preeclampsia, high AFP, hCG, and inhibin-A levels and low PAPP-A and NT levels were found to be significantly correlated (P<0.05). Elevated second-trimester inhibin- A levels were associated with preeclampsia (odds ratio 2.843), low birth weight (odds ratio 1.446), and preterm labor (odds ratio 1.287), and while decreased first-trimester PAPP-A levels were associated with preeclampsia (odds ratio 0.51) and preterm labor (odds ratio 0.75). CONCLUSION: First- and second-trimester maternal serum markers screening can be used for predicting high-risk pregnancies.
Sujets)
Femelle , Humains , Nouveau-né , Grossesse , Alphafoetoprotéines , Marqueurs biologiques , Gonadotrophine chorionique , Syndrome de Down , Oestriol , Nourrisson à faible poids de naissance , Dépistage de masse , Dossiers médicaux , Mesure de la clarté nucale , Travail obstétrical prématuré , Pré-éclampsie , Complications de la grossesse , Issue de la grossesse , Grossesse à haut risque , Protéine A plasmatique associée à la grossesse , Diagnostic prénatal , Études rétrospectivesRésumé
We report a 48-year-old man with laryngeal cancer who received a massive cisplatin toxic overdose without intravenous prehydration through an error in prescription. He received 400 mg/m2 of cisplatin over a 4-day period. On day 4, he exhibited a broad range of cisplatin toxicities and emergency plasma exchange was started. From day 5 through 19, he underwent 9 cycles of plasma exchange and his plasma cisplatin concentration decreased from 2,470 ng/ml to 216 ng/ml. He completely recovered without any sequelae. No previous reports exist in the English literature of survival without complication after the administration of such a high cisplatin dosage without prehydration.