RESUMO
OBJECTIVE: To determine whether fetal sex can be predicted from fetal DNA retrieved transcervically from the lower part of the uterine cavity in the first trimester of pregnancy. DESIGN: Prospective observational study. SETTING: St James's University Hospital, Leeds. SUBJECTS: 33 women undergoing legal termination of pregnancy at 9 to 13 weeks gestational age. INTERVENTIONS: Before termination of pregnancy samples for DNA analysis were obtained with cotton wool swabs from the vagina, cervix and transcervically in 26 women. In the other seven women samples were obtained using a transcervical cell retrieval (TraCeR) procedure involving flushing the lower uterine cavity with 5 ml saline. MAIN OUTCOME MEASURES: Detection of Y-chromosome specific DNA sequences by the polymerase chain reaction (PCR) in cotton wool swabs taken from the lower uterus in the first trimester of pregnancy to predict fetal sex in comparison with standard cytogenetic analysis. Histological and immunohistochemical analysis of samples obtained by flushing of the lower uterine cavity (TraCeR) to confirm the presence of trophoblast. RESULTS: Fetal sex was predicted accurately in 25 of the 26 pregnancies investigated. Immunohistochemical analysis identified syncytial trophoblast fragments in all seven pregnancies investigated by TraCeR. CONCLUSION: Trophoblast may be retrieved from the lower uterus in the first trimester by swabs or TraCeR. When purification of these syncytial fragments can be achieved using immuno-magnetic technology, this test will enable prenatal diagnosis of single gene defects in the fetus by the polymerase chain reaction.
Assuntos
DNA/análise , Amplificação de Genes , Análise para Determinação do Sexo , Colo do Útero/química , Feminino , Humanos , Masculino , Reação em Cadeia da Polimerase , Gravidez , Primeiro Trimestre da Gravidez , Diagnóstico Pré-Natal/métodos , Estudos Prospectivos , Cromossomos Sexuais/química , Equipamentos Cirúrgicos , Vagina/químicaRESUMO
Urinary symptoms before and after total abdominal hysterectomy in a study group of 80 pre-menopausal women were compared with those in a control group of 78 pre-menopausal women who had dilatation and curettage alone. No urinary symptom was found more commonly after hysterectomy than after curettage, whilst stress incontinence was less common in the study group. Transient symptoms occurred more frequently after hysterectomy.
Assuntos
Histerectomia/efeitos adversos , Transtornos Urinários/etiologia , Adulto , Dilatação e Curetagem/efeitos adversos , Feminino , Humanos , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Tempo , Incontinência Urinária por Estresse/etiologiaRESUMO
The Stamey procedure was performed on 21 women aged 65 to 81 years; 17 were cured (completely dry) or significantly improved (maximum 1 pad/day). Urethral length was significantly increased by the operation but maximum urethral pressure and maximum flow rate were unchanged. Complications were few.
