[Exchange amnioinfusion in conceptus with laparoschisis (first experience)]. / Výmenná amnioinfúzia u plodov s laparoschízou (Prvé skúsenosti).

OBJECTIVE: During amnioinfusion exchange (AE) a certain amount of amniotic fluid is repeatedly extracted and the same amount of physiological solution is consequently instilled into the amniotic fetal cavity. The aim of this procedure is to dilute the amniotic fluid that surrounds the eviscerated organs of fetuses with laparoschisis so as to avoid the genesis of fibrous coating on these organs. DESIGN: Prospective study. SETTING: Gynekologicko-pôrodnícka klinika SZU, FNsP akad. L. Dérera, Bratislava, Slovakia. METHODS: We have executed AE in five fetuses with laparoschisis since June 2002. Two patients underwent the treatment 2 times during the 32nd and 36th weeks of gestation. Two other patients were treated once during the 32nd week and one patient once during the 36th week. Under ultrasound control we used a spinal needle to extract 120-180 ml of dense, cloudy amniotic fluid. Consequently, we instilled the same amount of physiological solution warmed up to the temperature of 37 degrees C into the amniotic cavity through antibacterial filter. The fetuses were monitored cardiotocographically and with the help of ultrasound flowmetry in umbilical vessels, before and after the treatment. RESULTS: The AE were successful and without complications in all five cases. All patients delivered via elective caesarean section during the 36th - 37th gestation week. One patient delivered 24 hours after second AE due to the danger of intrauterine fetal hypoxia that was verified cardiotocographically. The other patients delivered 1-4 weeks after AE. CONCLUSION: The significance of AE lies primarily in the reduction of the occurrence of fibrous coating on eviscerated organs. It enables postnatal primary surgical closure of the defect in the front abdominal wall, an earlier onset of intestine peristalsis, transition from parenteral to peroral nutrition and shorter hospitalization.

[Rapid prenatal diagnosis of cystic fibrosis using the polymerase chain reaction: results of the first 5 cases]. / Rýchla prenatálna diagnostika cystickej fibrózy metódou polymerázovej ret'azovej reakcie (PCR): výsledky prvých piatich vysetrení.

Cystic fibrosis (CF) is an autosomal recessive lethal disease with an incidence in Slovakia of 1 affected in 1800 newborns. Within a year the incidence amounts to about 50 cases. Though the responsible gene has already been cloned, the only effective approach to prevention is prenatal diagnosis in the first and second trimester of pregnancy. The paper presents the results of the first five cases of prenatal diagnosis of CF established by the new rapid method of DNA analysis, polymerase chain reaction (PCR). Delta F508 deletion mutation and closely linked DNA polymorphism KM19/PstI were assessed. In two of the five cases studied the fetuses were found to be affected and pregnancy termination was indicated. To exclude the possibility of fetal DNA contamination with maternal DNA, the hypervariable DNA polymorphism VNTR apoB was determined simultaneously. The advantages of this approach are demonstrated on cases of prenatal diagnosis performed in two families where contamination of fetal DNA could be excluded. The value of the PCR method is being compared with that of Southern's hybridization method. (Tab. 2, Fig. 4, Ref. 27.).

[Intersexual differences in the levels of trace elements in amniotic fluid in the 2d trimester of pregnancy]. / Intersexuálny rozdiel koncentrácie niektorých stopových prvkov v plodovej vode v II. trimestri tehotnosti.

The authors assessed during comprehensive examination of amniotic fluid obtained by transabdominal amniocentesis on account of genetic indication during the second trimester of normal pregnancy between the 15th and 22nd week of gestation four selected trace elements - Zn, Cu, Pb and Cd, using the method of atomic absorption spectrometry. One of the criteria for evaluation of the results was also the relationship of the concentration of the selected trace elements and sex of the foetus. In 157 amniotic fluids collected during the 16th-19th week of gestation they recorded a significantly elevated lead level in male foetuses. During the 17th week normal pregnancy they found also a significantly increased zinc concentration in amniotic fluid of female foetuses. The authors are so far unable to interpret these interesting results which will be the subject of future investigation.

Blood and placental concentrations of cadmium, lead, and mercury in mothers and their newborns.

Placental transfer of cadmium, lead and mercury was studied under the conditions of environmental exposures of pregnant women to these heavy metals. Fifty pregnant women from industrial area and a similar control group from a semirural area were examined. Cadmium, lead and total mercury levels were determined in maternal erythrocytes and plasma, in placenta, and in erythrocytes and plasma of umbilical cord blood using atomic absorption spectrophotometry. Except for the cadmium plasma concentration in the control area, levels of the three metals were higher in maternal than in cord blood. The mean plasma values (arithmetic mean) of cadmium, lead, and mercury in industrial area were 0.53, 6.37, and 0.37 micrograms.100 ml-1 in maternal blood and 0.30, 4.82, and 0.31 micrograms.100 ml-1 in cord blood. Highest values of the correlation coefficients were found between the cadmium and mercury concentrations in maternal and cord blood erythrocytes. No striking effect of the place of residence of pregnant women on the heavy metal concentrations in biological materials could be found.