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Biomedical subjects

H Cuckle

Publications and source records attributed to H Cuckle.

102 records · Page 6Linked to original sources

Maternal serum alpha-fetoprotein and diabetes mellitus.

Maternal serum alpha-fetoprotein (AFP) levels were measured from 12 to 24 weeks gestation in 27 singleton pregnancies in women with insulin-dependent diabetes mellitus and 90 controls without diabetes who were matched for gestational age. The geometric mean AFP level among the diabetic pregnancies was 60 per cent of that in the controls, a difference which was statistically significant (P less than 0.01). The difference in AFP level between diabetic patients and controls was most marked in sera taken before 21 weeks gestation.

Adult↗

Maternal serum alpha-fetoprotein levels in triplet and quadruplet pregnancy.

Maternal serum alpha-fetoprotein (AFP) levels were higher in six triplet pregnancies and three quadruplet pregnancies than in control singleton pregnancies matched for maternal age, parity and time of gestation at which the serum sample was taken. Between 12 and 23 weeks of pregnancy, the average AFP levels among the triplet pregnancies was three times that found in the singleton pregnancies, and the level in the quadruplet pregnancies was even higher. Maternal serum AFP levels appear to be associated with the number of fetuses in utero.

Female↗

Maternal serum alpha-fetoprotein and birth weight in twin pregnancies.

In 102 twin pregnancies the mean birth weight of each pair showed a statistically significant negative association with maternal serum alpha-fetoprotein (AFP) levels early in pregnancy. Women with AFP levels of four or more times the median value for singleton pregnancies gave birth to infants with a median birth weight 660 g less than that of infants born to women with AFP levels between 1.0 and 1.5 times the median for singleton pregnancies. Maternal serum AFP has been shown to be an early predictor of low birth weight delivery in singleton pregnancies. Our results indicate that this is also true in twin pregnancies.

Birth Weight↗

Maternal serum-alpha-fetoprotein and low birth-weight.

High maternal serum-alpha-fetoprotein (A.F.P.) concentrations in the first half of pregnancy were associated with prematurity and high perinatal mortality. 94 singleton pregnancies without neural-tube defects but with A.F.P. levels equal to or greater than three times the normal median resulted in the birth of infants weighing, on average, 357 g less than controls (P less than 0-001). The mean head circumference of the infants was also smaller than that of the controls. The 1 stillbirth and 3 neonatal deaths yielded a mortality-rate more than three and a half times that for singleton births without neural-tube defects at the same hospital in the years 1974-76. The results suggest that some pregnant women who will deliver low-birth-weight infants at high risk of perinatal death may be identified by means of serum-A.F.P. measurement early in pregnancy.

Abortion, Spontaneous↗

Maternal serum-alpha-fetoprotein measurement in antenatal screening for anencephaly and spina bifida in early pregnancy. Report of U.K. collaborative study on alpha-fetoprotein in relation to neural-tube defects.

Nineteen centres collaborated in a study to determine the efficiency of maternal serum-alpha-fetoprotein (A.F.P.) measurement as a method of screening for neural-tube defects (N.T.D.S.) between 10 and 24 weeks of pregnancy. Data were collected on 18 684 singleton pregnancies and 163 twin pregnancies without fetal N.T.D.s, and on 301 singleton pregnancies with fetal N.T.D.s (146 with anencephaly, 142 with spina bifida, and 13 with encephalocele). The best time for detecting open spina bifida by measuring maternal serum-A.F.P. is at 16-18 weeks of pregnancy. In clinical practice, serum-A.F.P. cut-off levels expressed as multiples of the normal median may be more convenient to use than percentiles because they are easier to derive and more stable. Also, the proportion of affected pregnancies with serum-A.F.P. levels exceeding a given multiple of the median is unlikely to vary significantly from centre to centre or over time. In contrast, the proportion of unaffected pregnancies with A.F.P. levels exceeding a given multiple of the normal median will vary depending on the precision with which serum-A.F.P. and gestation are measured. At 16-18 weeks of pregnancy 88% of cases of anencephaly, 79% of cases of open spina bifida, and 3% of unaffected singleton pregnancies had A.F.P. levels equal to or greater than 2-5 times the median for unaffected singleton pregnancies. At this gestation age the numbers of unaffected pregnancies with A.F.P. levels above 2-5 times the normal median can be reduced by about a third if women with borderline A.F.P. levels are retested, although this would not greatly change the detection-rate of affected pregnancies. In the United Kingdom as a whole, women with serum-A.F.P. levels above 2-5 times the normal median at 16-18 weeks of gestation will have an approximately 1-in-20 chance of having a fetus with open spina bifida; the risk of having any N.T.D. will be approximately 1 in 10. The results of this study indicate that screening pregnant women by measuring the concentration of A.F.P. in their serum is an effective method of selecting women for ultrasonography and amniocentesis so that N.T.D.s can be diagnosed in utero.

Anencephaly↗

Maternal serum alpha-fetoprotein and spontaneous abortion.

The relationship between spontaneous abortion and maternal serum alpha-fetoprotein (AFP) levels was investigated between 9 and 25 weeks of pregnancy. Seven out of 126 (5-6 per cent) women who had spontaneous abortions had raised maternal serum AFP levels at their antenatal booking visit compared to 4 out of 247 (1-6 per cent) control patients who were delivered of single liveborn infants, a statistically significant differences. The raised AFP concentrations were, however, associated with spontaneous abortion only if the serum samples had been taken immediately before, or at sometime after the abortion was first clinically suspected. This suggests that high levels do not predict the development of abortion in women who have not already threatened to abort. It is therefore unlikely that women who have not already threatened to abort. Therefore, when maternal serum AFP levels are used to screen for fetal neural tube defects, women referred for a diagnostic amniocentesis on account of a high level are unlikely to have been selected on the basis of a tendency to abort.

Abortion, Spontaneous↗

Cystic fibrosis screening strategies.

Cystic fibrosis is the most common single gene disorder in Western populations. With the discovery of the principal genetic mutations responsible for the disease, screening has become feasible. The challenge is now to devise an effective screening strategy. Various approaches are possible, and each has its own merits, but on balance antenatal screening would appear to be the most practical.

Cystic Fibrosis↗