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H S Cuckle

Publications and source records attributed to H S Cuckle.

120 records · Page 7Linked to original sources
PubMed1980

Maternal serum alpha-fetoprotein and birth weight.

Maternal serum alpha-fetoprotein (AFP) levels between 16 and 18 weeks of pregnancy were studied in relation to birth weight among 4198 singleton pregnancies resulting in a liveborn or stillborn infant without a neural tube defect. The highest mean birth weight (3365 g) was found among infants born to women with AFP values in the range 0.50 to 0.74 times the normal median for the relevant week of gestation. As the AFP decreased from this level to less than 0.25 times the median, the birth weight decreased by 193 g and the proportion of infants weighing 2500 g or less increased from 4 per cent to 11 per cent. As the AFP level increased from 0.50 to 0.74 times the median to 3.0 times the median or greater, the birth weight decreased by 371 g and the proportion of infants weighing 2500 g or less increased from 4 to 22 per cent. The negative association was the more important of the two since the magnitude was greater and it affected 92 per cent of pregnancies. The positive association among women with low ARP levels was substantially reduced when the analysis was restricted to women who had spontaneous labours. It seems that this minor positive association arises mainly because women in whom gestation is over-estimated tend to have both a low AFP and, later, an apparently prolonged pregnancy leading to the elective delivery of an infant who is, in fact, born early.

Birth Weight↗
PubMed1980

Birth weight of infants with spina bifida cystica.

The mean birth weight of 189 singleton infants with spina bifida cystica (including 21 with encephalocele) was statistically significantly less than the mean birth weight of 3816 singleton infants without neural tube defects, 0.20 kg less among male infants and 0.24 kg less among female infants. Most, if not all, of this difference in birth weight was due to the spina bifida infants being light for their gestational age. The difference could not be explained by differences in parity or social class.

Birth Weight↗
PubMed1979

Amniotic-fluid acetylcholinesterase as a possible diagnostic test for neural-tube defects in early pregnancy.

Raised levels (greater than or equal to 4.5 munits/ml) of acetylcholinesterase (AChE) activity in amniotic fluid at 14--23 weeks of pregnancy were significantly associated with open fetal neural-tube defects. Out of 72 pregnancies correctly classified by the amniotic-fluid alpha-fetoprotein (A.F.P.) test, 2 of 56 without neural-tube defects and all 16 with open neural-tube defects (8 with anencephaly and 8awith open spina bifida) had raised levels of AChE. Out of 5 pregnancies misclassified by the A.F.P. test (4 without neural-tube defects and 1 with open spina bifida), only 1 was misclassified by the AChE test--namely, one of those without a neural-tube defect. Thus, only 3 of the 77 pregnancies tested were misclassified by the quantitative AChE test. A qualitative test for an isoenzyme of AChE found in cerebrospinal fluid correctly classified these 3 pregnancies. These findings suggest that the analysis of AChE in amniotic fluid may be a useful test in the diagnosis of open neural-tube defects.

Acetylcholinesterase↗
PubMed1979

Antenatal screening in Oxford for fetal neural tube defects.

Between May 1975 and the end of 1977, 6443 antenatal patients were screened mainly between 16 and 22 weeks of pregnancy for neural tube defects (NTDs) at the John Radcliffe Hospital, Oxford, by maternal serum alpha-fetoprotein (AFP) measurement; a take-up of 72 per cent. Seventeen out of 18 (94 per cent) patients with open NTD pregnancies (9 out of 9 with anencephaly and 8 out of 9 with open spina bifida) had positive screening tests, and all except one were offered and accepted a termination of pregnancy. Two hundred and forty-five (3.8 per cent) patients with unaffected pregnancies also had positive screening tests, although only 1.4 per cent had an amniocentesis. Following ultrasonography, about 50 per cent of patients with unaffected pregnancies with positive screening tests were not offered an amniocentesis because they had a multiple pregnancy or their gestational age had been underestimated. The odds of having a fetus with an NTD among the women who had an amniocentesis was about 1 to 6 (1 to 11 for open spina bifida alone). Two apparently normal pregnancies were terminated. A survey of the acceptability of the screening programme among a consecutive sample of 73 patients who knew that they had a positive screening test revealed that all except one had no objection to screening in general, and 68 (93 per cent) wanted to be tested again in a future pregnancy. The approximate direct cost of the programme was 2 pounds to 3 pounds per patient screened, or about 1000 pounds per NTD detected (about 2200 pounds per open spina bifida detected).

Amniocentesis↗
PubMedDate not supplied

A survey of diagnostic amniocenteses in Oxford from 1974-1981.

A survey was conducted of the results of mid-trimester diagnostic amniocenteses in the Oxford Region from 1974 to 1981. The survey used data relating to all 4357 singleton pregnancies in which an amniocentesis was performed during this period. Follow-up information on outcome was obtained in respect of 4284 (98 per cent) pregnancies. A cell culture to determine karyotype and an alpha-fetoprotein determination was carried out in all cases. From 1974 to 1981 amniocenteses became increasingly common, rising from 2 to 32 per 1000 births. The most common indication for amniocentesis was a high risk of a chromosome abnormality--56 per cent of all amniocenteses. Within this group advanced maternal age was responsible for 89 per cent of the cases. The next most common indication was a high risk of a neural tube defect (37 per cent of all amniocenteses) --in 1974 a raised maternal serum alpha-fetoprotein level accounted for only 4 per cent of these; by 1981 this had risen to 67 per cent. There were seven false-positive and 132 true-positive diagnoses of neural tube defect; since 1981, with the introduction of amniotic fluid acetylocholinesterase determination as a secondary diagnostic test for neural tube defects, there have been no further false-positive diagnoses. In 1981 76 per cent of women aged 35 years or more did not have an amniocentesis. It is not known to what extent this was due to not offering women in this age group amniocentesis or to women not accepting such an offer.

Abortion, Spontaneous↗
PubMedDate not supplied

An automated image analysis method for the measurement of neutrophil alkaline phosphatase in the prenatal screening of Down syndrome.

OBJECTIVES: (1) To develop an image analysis method for the measurement of neutrophil alkaline phosphatase (NAP); (2) To establish a correlation of urea-resistant fraction of NAP (URNAP)/NAP scoring between the manual and automated methods, and (3) to assess the value of URNAP/NAP in the prenatal screening of Down syndrome. STUDY DESIGN: Slides from 15 unaffected controls were blindly scored by both methods. The Pearson test was used for correlation analysis. Slides from 15 Down syndrome pregnancies and 25 unaffected controls were scored manually. RESULTS: A coefficient r = 0.93 was obtained comparing the URNAP/NAP scores generated by the two methods. Average time for scoring by the automated method was 8 min. The median URNAP/NAP values for Down syndrome and unaffected controls were 112/86.1 and 51/51.5, respectively. CONCLUSIONS: Scores obtained by both methods highly correlate. Automated scoring is threefold faster. Down syndrome cases have higher URNAP/NAP scores compared to unaffected controls, which suggests that URNAP/NAP is an extremely useful marker for mid-trimester prenatal screening.

Alkaline Phosphatase↗