Increased nuchal translucency and decreased fetomaternal transfusion after chorionic villus sampling.

OBJECTIVE: To investigate the relationship between nuchal translucency (NT) and fetomaternal transfusion (FMT) after chorionic villus sampling (CVS). METHODS: The level of FMT was determined in 272 viable, singleton pregnancies in which 10-14-week ultrasound scanning, NT measurement and CVS for fetal karyotyping had been performed. The pre-CVS NT was measured transvaginally, and the women were divided into two groups, i.e. those with NT < 2.5 mm (Group 1) or >or= 2.5 mm (Group 2). The level of FMT was determined via the maternal serum alpha-fetoprotein levels before and after CVS. FMT was analyzed in relation to the pre-CVS NT. RESULTS: Of the 272 pregnancies, 213 were in Group 1 and 59 in Group 2. The mean levels of FMT after CVS were 23.3 +/- 12.2 and 5.4 +/- 2.9 micro L in Groups 1 and 2, respectively (P < 0.01). An FMT > 100 micro L was found in 19 cases in Group 1, whereas the maximum in Group 2 was 67.2 micro L. Aneuploidies were diagnosed in 17 cases, 15 (88.2%) of them in Group 2. When the pregnancies with adverse outcome were excluded from the two groups, a higher level of FMT was observed in Subgroup 1 than in Subgroup 2 (P < 0.01). CONCLUSIONS: The mean level of FMT after CVS was significantly lower in pregnancies with an increased pre-CVS NT, a relationship observed in euploid pregnancies also. An increased pre-CVS NT seems to be inversely correlated with the FMT increase after CVS. Further studies are planned to investigate the background to this phenomenon.

Four years experience of first-trimester nuchal translucency screening for fetal aneuploidies with increasing regional availability.

BACKGROUND: A prospective screening study was carried out at the regional genetic and perinatal center in South Hungary in order to determine the efficiency of first-trimester nuchal translucency screening for fetal aneuploidies, following augmentation of the availability of nuchal translucency screening in the region by the inclusion of newly-trained hospital sonographers. METHODS: Nuchal translucency thickness was measured by transvaginal sonography in 7,044 women with singleton or multiple pregnancies at weeks 10-12. Fetal karyotyping was performed when the nuchal translucency was . or = 2.5 mm, and in women with fetuses at high cytogenetic risk. RESULTS: Follow-up was performed in 6,841 of the 7,044 screened women. An abnormal karyotype was found in 33 cases (0.48%). The level of increased nuchal translucency was 4.5% at a cutoff of > or = 2.5 mm, and 2.8% at a cutoff of > or = 3 mm. Seventeen cases of trisomy 21, eight of trisomy 18, four of trisomy 13, one of 45,X, one of triploidy and two cases with other chromosomal abnormalities were detected. In the 33 fetuses with a chromosomal abnormality, the nuchal translucency thickness was <2.5 mm in a case of trisomy 18, > or = 2.5 mm in 32 cases and > or = 3 mm in 28 cases. With cutoffs of 2.5 mm and 3 mm, the sensitivity was 96.97% and 84.85%, respectively. CONCLUSIONS: Application of a nuchal translucency thickness cutoff of 2.5 mm is highly efficient for the screening of fetal aneuploidies at 10-12 weeks. This efficiency can be maintained by increasing the regional availability of nuchal translucency screening through the inclusion of newly-trained hospital sonographers.

Antimutagenicity of benzo[a]phenothiazines in chemically induced mutagenesis.

The antimutagenicity of seven benzo[a]phenothiazines was screened against Salmonella typhimurium strain TA98 treated with 4-nitro-o-phenylenediamine which is a specific mutagen to the strain, and the results were compared to the antimutagenic activity of chlorpromazine (8), one of the 2-chlorophenothiazine derivatives-which have been shown to be the most effective mutagen inhibitors. Benzo[a]phenothiazines with methyl, oxo or hydroxyl substituent(s) at position 5, 6, 9 or 10 were used in the screening tests. 6-Hydroxy-5-oxo-5H-benzo[a]phenothiazine (6) reduced the induced mutation by 27%, being a more potent antimutagenic agent than chlorpromazine (8). The study of antimutagenicity is of great interest for the development of cancer chemopreventive agents which stop cancer progression in multistage carcinogenesis in which successive mutation sequences are required for a progression into full-fledged metastatic cancer.

Antimutagenicity of benzo[a]phenothiazines in chemically induced mutagenesis.

Antipsychotic phenothiazines are known to have antimutagenic activities. The antimutagenicity of seven Benzo[a]phenothiazines was screened against Salmonella typhimurium strain TA98 treated with 4-nitro-o-phenylenediamine (4-NPD) which is a specific mutagen to this strain, and was compared to the antimutagenic activity of chlorpromazine, a 2-chlorphenothiazine derivative which has been shown to be the most effective mutagen inhibitor in the model. Benzo[a]phenothiazines are variously substituted by methyl-, oxo- and/or hydroxyl-substituent(s) at 5, 6, 9 and/or 10 positions(s). 9-Methyl-12H-benzo[a]phenothiazine [3] reduced the 4-NPD induced mutation by 30 percent, being a more potent antimutagenic agent than chlorpromazine. The study of antimutagenicity is of great interest in the development of cancer chemopreventive agents which halt cancer progression in multistage carcinogenesis, where successive mutation sequences are required to evolve into full-fledged metastatic cancer.