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Biomedical subjects

C H Rodeck

Publications and source records attributed to C H Rodeck.

At least 289 records · Page 16Linked to original sources
PubMed1980

Dual diagnosis of prenatal haemophilia A by measurement of fetal factor VIIIC and VIIIC antigen (VIIICAg).

Procoagulant factor VIII (VIIIC) and procoagulant factor VIII antigen (VIIICAg) were measured in 20 samples of pure fetal blood obtained by fetoscopy at mid-term from non-haemophilic fetuses. VIIIC levels ranged from 25 to 89 U/dl (mean 43.5) and VIIICAg from 11 to 43 U/dl (mean 22.3). Samples from 39 consecutive fetuses at risk of haemophilia A gave results indicating haemophilia in 11, and these pregnancies were terminated at the parents' request. Of the remaining 28, 18 have resulted in normal births, 8 still await delivery, and 2 pregnancies were terminated for non-haematological reasons. The results confirm that pure fetal blood can be aspirated fetoscopically for plasma assays of both VIIIC and VIIICAg. Dual measurement enhances the reliability of predicting or excluding haemophilia A, and makes prenatal diagnosis a dependable option for known or potential carriers seeking this information.

Antigens↗
PubMed1980

Prenatal diagnosis of epidermolysis bullosa letalis.

The prenatal diagnosis of epidermolysis bullosa letalis was made by electron microscopy of a biopsy specimen of fetal skin taken under direct vision by fetoscopy at 18 weeks' gestation. The diagnosis was confirmed after termination of pregnancy. Abnormalities were found in the number, size, and scanning-electron-microscope appearance of amniotic-fluid cells. These techniques have considerable potential for rapid diagnostic studies in a number of other conditions.

Adult↗
PubMed1980

Fetoscopy guided by real-time ultrasound for pure fetal blood samples, fetal skin samples, and examination of the fetus in utero.

Techniques for sampling pure fetal blood, fetal skin and for fetal examination by fetoscopy are described in detail after experience gained in 151 diagnostic fetoscopies on 145 patients. Of particular importance were a real-time scanner and a particle size analyser. The region of insertion of the umbilical cord into the placenta was the optimum site for obtaining pure fetal blood, and this was achieved in 136 out of 143 patients (95 per cent) sampled at 18 to 23 weeks gestation. This made maternal blood transfusion before prenatal diagnosis of haemoglobinopathies unnecessary. An anterior placenta rarely prevented successful fetoscopy, and often made fetal blood sampling easier. Four fetal losses (3.7 per cent) were judged to be due to fetoscopy.

Blood Specimen Collection↗
PubMed1980

Development of cell-mediated lympholysis in human foetal blood lymphocytes.

White cells from pure foetal blood obtained by fetoscopy, or from the cord at birth, were sensitized in mixed lymphocyte culture with irradiated adult peripheral blood lymphocytes. After 6-8 days of culture they were assayed in a standard 4-hr 51Cr-release cytotoxicity assay (CML) using lymphoblastoid cell targets from the stimulator cell donor. The age of the foetuses ranged from 15-22 weeks of gestation. Third-party target cells and adult blood served as controls. The mean cytotoxic responses of cord (11 donors) and adult (10 donors) blood lymphocytes were not significantly different and had similar kinetics. Foetal lymphocytes (25 donors) displayed a wide range of reactivity with half, scattered throughout the age range, totally negative and a further 23% with marginal responses. Definite cytotoxicity was found in the remainder, but not before the 18th week; these responses were evenly distributed in the range 18-22 weeks. Third-party responses were never more than one-quarter of the specific cytotoxicity. It was shown that the negative and very weak responses were almost certainly not due to technical factors. It is concluded that the majority of human foetuses in the range 15-22 weeks, though capable of giving clear mixed lymphocyte reactions, cannot develop full effector function as measured by the CML assay.

Adult↗
PubMed1980

Value of fetoscopy in prenatal diagnosis.

A technique of fetoscopy and fetoscopic blood sampling is described that makes maximum use of ultrasound scanning. A particle size analyser is also an integral part of the procedure. The results are based on 170 fetoscopies, 85 of which were performed for diagnostic reasons. The anterior placenta is rarely a cause of failure and in many instances makes fetal blood sampling easier. Pure fetal blood is obtainable from the umbilical cord insertion in 95% of cases sampled after 18 weeks' gestation. Fetal mortality may be as low as 3% and long-term adverse sequelae have not yet been discovered.

Congenital Abnormalities↗
PubMed1979

Plasma assay of fetal factors VIIIC and IX for prenatal diagnosis of haemophilia.

Fetal blood unmixed with maternal blood or amniotic fluid was obtained by direct-vision fetoscopy in 22 consecutive cases at 15--22 weeks' gestation; the investigation was done either for prenatal diagnosis or before therapeutic abortion. Fetal plasma factors VIIIC and IX averaged 50 I.U./dl (S.D. 12.8) and 12.5 I.U./dl (S.D. 2.4), respectively. Two male fetuses at risk of haemophilia had normal factor VIIIC levels by these criteria, and both pregnancies ended in the birth of a normal boy. Five others gave 3 normal and 2 haemophilic results, which were confirmed in two of the three terminated pregnancies.

Amniocentesis↗
PubMed1978

Sampling pure fetal blood by fetoscopy in second trimester of pregnancy.

A technique for fetal blood-sampling in the second trimester of pregnancy (between 16 and 22 weeks' gestation) combining fetoscopy with real-time ultrasound was used in 48 attempts at fetal blood-sampling. Specimens containing fetal red cells with or without amniotic fluid or maternal blood, and adequate for diagnosing haemoglobinopathies, were obtained in 45 of the 48 fetoscopies. Sampling was successful in all 18 patients with a posterior placenta, and in 27 of the 30 with an anterior placenta. In 22 of the last 27 consecutive fetoscopies pure fetal blood was taken; the placenta was anterior in 16 and posterior in six. Out of 17 cases sampled between 18 and 22 weeks' gestation pure fetal blood was obtained in 16. The volume of the samples varied from 50 to 500 microliter. The ability to obtain pure fetal blood consistently even when the placenta is anterior will increase knowledge of fetal physiology and the scope of prenatal diagnosis.

Blood Specimen Collection↗
PubMed1978

Early prenatal diagnosis of neural-tube defects by ultrasound-guided fetoscopy.

In three fetuses with neural-tube defects (N.T.D.s) the lesions were clearly seen by fetoscopy in the second trimester. In a fourth fetus, in which the diagnosis of N.T.D. was suspected because of raised amniotic-fluid alpha-fetoprotein, spina bifida was excluded by fetoscopic examination and a normal baby was delivered at term. Ultrasound-guided fetoscopy has a place in the diagnosis of N.T.D.s when the results of other investigations are conflicting or inconclusive, and may be useful in assessing the severity of a lesion.

Amniocentesis↗
PubMed1977

Secondary liposarcoma of the ovary.

This report is the first description of a secondary ovarian liposarcoma. The primary growth was in the mediastinum. The growth rate of the ovarian tumor was very rapid, but the patient died of cardiopulmonary causes. The mode of spread is discussed, and it probably occurred by transcelomic migration and surface implantation.

Adult↗
PubMed1977

The relation between umbilical cord tissue prostaglandin E2 levels, mode of onset of labour, fetal distress and method of delivery.

The tissue concentrations of prostaglandin E2 (PGE2) were measured by radioimmunoassay in components of the umbilical cord. The levels were significantly higher in the walls of arteries than in non-vascular tissue from the umbilical cord. The highest values were found after emergency Caesarean sections and the lowest after induced ending in normal delivery. The use of forceps and the presence of fetal distress were both associated with significantly raised tissue concentrations of PGE2.

Cesarean Section↗
PubMed1976

Maternal plasma alpha-fetoprotein in normal and complicated pregnancies.

Plasma alpha-fetoprotein (AFP) has been estimated by radioimmunoassay in healthy non-pregnant adults, some of whom were taking oral contraceptives, and in women with normal and complicated pregnancies. A curve with the 90 per cent range in normal pregnancy was established. The prop&rtion of values below the 5th centile in complicated pregnancies was significantly greater than in uncomplicated pregnancies. However, three-quarters of the estimations in the complicated groups lay within the 90 per cent range. Nor correlation was found between maternal plasma AFP values and the incidence of fetal distress, small-for-dates babies or perinatal mortality. It is concluded that the measurement of maternal plasma AFP is not reliable test for predicting fetal well-being.

Congenital Abnormalities↗