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Biomedical subjects

M S Golbus

Publications and source records attributed to M S Golbus.

At least 19 recordsLinked to original sources
PubMed1979

Thalassemia and pregnancy: results of an antenatal screening program.

A thalassemia screening program was implemented at our institution using the finding of a mean corpuscular volume less than 80 fl as the index of abnormality. Further evaluation using hemoglobin (Hb) electrophoresis and serum iron studies was carried out according to the scheme detailed below. A diagnosis of thalassemia was made in 33 women (42 pregnancies). Eight patients had alpha-thalassemia trait, 23 beta-thalassemia trait, and two Hb H disease. Thalassemia trait did not have any adverse effect on pregnancy outcome. In two couples the fetuses were at risk for homozygous disease and in one couple the fetus was at risk for sickle cell beta-thalassemia. The screening program described is an effective and inexpensive means of detecting thalassemia in an antenatal population and is applicable to most every clinic or office setting.

Adult↗
PubMed1979

Prenatal genetic diagnosis in 3000 amniocenteses.

We analyzed 3000 consecutive amniocenteses for prenatal diagnosis to assess the frequency of abnormalities, safety of the procedure, technical and interpretive difficulties and overall diagnostic accuracy. Chromosomal abnormalities were detected in 2.4 per cent of the 2404 pregnancies tested because of advanced maternal age (greater than or equal to 35 years), in 1.2 per cent of 240 monitored because of prior trisomy 21 and in 9.1 per cent of 55 examined for other cytogenetic indications. Mosaicism was detected in 0.4 per cent, and unexpected translocations in 0.4 per cent. Amniotic fluid was obtained on the first attempt in 99.3 per cent of the last 1000 cases, and cultures established from 99.7 per cent of patients attending our clinic. The fluid was discolored in 1.2 per cent of patients, a quarter of whom had missed abortions. The rate of spontaneous abortion after amniocentesis was 1.5 per cent. There were 14 diagnostic errors, six serious enough to affect the outcome of pregnancy. The karyotyping error rate was 0.07 per cent. We conclude that prenatal diagnosis is safe, highly reliable and extremely accurate.

Abortion, Spontaneous↗
PubMed1979

Partial trisomy for the distal long arm of chromosome 5 (region q34 leads to qter). A new clinically recognizable syndrome.

This report describes a family in which eight individuals in three generations had mental retardation in association with a characteristic pattern of clinical problems and physical abnormalities including short stature, eczema, hernias, delayed puberty, dysmorphic facies and digital anomalies. The family history was consistent with a chromosomal rearrangement with transmission through balanced carriers. Routine ASG banding studies showed extra chromosomal material on a chromosome 16 but failed to demonstrate any differences between the affected individuals and the presumed carriers. However, subsequent studies utilizing trypsin banding and microspectrophotometry of individual chromosomes demonstrated that the affected individuals were partially trisomic for the distal band of the long arm of chromosome 5 and that 0.273 units of a chromosome 5 were translocated to chromosome 16. This definitive cytogenetic diagnosis permitted accurate prenatal diagnosis to be carried out on the fetus of a balanced carrier female. The application of these techniques to previously obscure familial dysmorphic syndromes is recommended.

Abnormalities, Multiple↗
PubMed1979

Prenatal diagnosis of chromosomal abnormalities and neural tube defects.

We have reviewed the current status of prenatal diagnosis for chromosomal indications and for neural tube defects. The number of pregnancies monitored will increase as greater resources become available and as public education about genetics increases. The methodology has proved to be a powerful means of preventing the birth of individuals with significant genetic defects, thereby sparing both parents and society from the burdens produced by such disorders. In the future, it is likely to be even more effective.

Amniocentesis↗
PubMed1979

Anxiety engendered by amniocentesis.

Anxiety was measured and compared in three groups of 12 pregnant couples undergoing amniocentesis for prenatal diagnosis of chromosomal disorders. Significant elevations in anxiety were found in all groups prior to counseling on the day of the procedure and prior to receiving test results. Women who had previously given birth to a child with a chromosomal disorder displayed higher anxiety levels prior to amniocentesis than women whose indication for the procedure was age. Fathers in the previous trisomy group had higher anxiety levels prior to the receipt of test results as well as before the amniocentesis when compared to fathers in the maternal-age group. An experimental group of couples in which the women were over 35, received weekly calls from the genetic counselor. This intervention did not reduce median anxiety scores significantly for either men or women but did lower anxiety among the minority of extremely anxious mothers. Parental anxiety levels were interpreted based on interview data. Conditions which promote anxiety were contrasted to those which diminish it. Suggestions were made for amniocentesis counseling earlier in pregnancy and for identifying parents who would benefit by extra attention from counselors.

Amniocentesis↗
PubMed1978

Development in the first half of gestation of genetically abnormal human fetuses.

Linear measurements, total weight and organ weights were determined for 24 second trimester human fetuses with a cytogenetic or metabolic defect. The three fetuses with trisomy 13 or 18 tended to be smallest in all parameters. This data should be of value to other laboratories interested in human fetal growth. It demonstrates that the intrauterine growth retardation reported at term in cytogenetically abnormal newborns is already manifested at the eighteenth to twentieth week of gestation.

Body Height↗
PubMed1978

Habitual abortion.

Explore the source record for details and available documents.

Abortion, Habitual↗
PubMed1978

Prenatal diagnosis of hemoglobin H disease.

Hemoglobin H disease was diagnosed prior to the twenty-second week of gestation in a pregnancy at risk for homozygous alpha-thalassemia using the technique of DNA-DNA hybridization. Fetal DNA was obtained from amniotic fluid fibroblasts obtained during the thirteenth week of gestation and grown in culture. The fetal fibroblast DNA was hybridized to radioactive alpha-globin cDNA. The number of alpha-globin genes present in the fetus was determined by comparing results of hybridization studies on the fetal DNA to similar studies on subjects with well-defined alpha-thalassemia syndromes and with normal subjects. The diagnosis of hemoglobin H disease was confirmed at birth by studies of the cord blood. This study confirms the ability of DNA-DNA hybridization techniques to distinguish the three-gene defect of hemoglobin H disease from the lethal four-gene defect of homozygous alpha-thalassemia.

Alpha-Globulins↗
PubMed1978

Ultrasonography for guidance of amniocentesis in genetic counseling.

The value of preliminary ultrasonography as a guide for amniocentesis in the early second trimester of pregnancy was prospectively evaluated. One hundred and fifty patients were alternately assigned to a control group or to an ultrasound group who underwent examination with a real-time scanner immediately prior to amniocentesis. All amniotic fluid samples were assessed as to the presence of blood by: (1) visual observation during the amniocentesis; (2) appearance of the centrifugate; and (3) microscopic analysis. Ultrasonography did not reduce the failure rate, the incidence of multiple needle insertions, or the proportion of amniotic fluid samples containing blood.

Amniocentesis↗
PubMed1978

The prenatal diagnosis of genetic disorders.

Prenatal diagnosis has proven highly effective in assessing the status of fetuses at risk of all cytogenetic and of several biochemical and structural disorders with genetic etiologies. The original methodology, based on the cytogenetic and biochemical analysis of cultured amniotic fluid cells, has now been complemented by a wide variety of new techniques. These include several methods for fetal visualization (sonography, fetoscopy, x ray), sampling of fetal blood, and analysis of very small quantities of material. Additional approaches, based on these and other technologies, are likely to permit the prenatal diagnosis of an ever increasing number of genetic disorders. At the same time, the number of pregnancies monitored will increase as greater resources become available and as screening programs identify couples at risk of having genetically abnormal children prior to the birth of an affected child. Prenatal diagnosis is already a powerful means of preventing the birth of individuals with significant genetic defects, thereby sparing both individuals and society from the burdens that such disorders produce. In the future, it is likely to be even more effective.

Amniotic Fluid↗
PubMed1977

Prenatal diagnosis of Duchenne's muscular dystrophy.

Two pregnancies at risk for X-linked recessive Duchenne's muscular dystrophy were studied at 18 and 20 weeks. Fetal blood was obtained by placental aspiration for measurement of plasma creatine phosphokinase activity. Activity in the first fetus was 96 IU per liter, as compared to a control range of 0 to 150 IU per liter in 16 pregnancies not at risk for the disorder. The pregnancy continued, and the infant was normal after birth. In the second fetus creatine phosphokinase activity was significantly elevated to 540 IU per liter (P less than 0.001). Fetal blood also showed considerable hemolysis, an unusual observation in placental blood sampling. After abortion, examination of fetal muscle by light, phase and electron microscopy showed characteristic features of Duchenne's muscular dystrophy, including wide variation in muscle-fiber diameter and reduction in the number of fibers per fasciculus. These cases illustrate the potential usefulness of fetal plasma for prenatal diagnosis and, specifically, of creatine phosphokinase activity for diagnosis of muscular dystrophy.

Creatine Kinase↗
PubMed1977

Prenatal diagnosis of beta-thalassaemia and sickle-cell anaemia. Experience with 24 cases.

Prenatal diagnosis of beta-thalassaemia and sickle-cell anaemia was attempted in 24 pregnancies. Adequate amounts of fetal blood (for studying globin-chain synthesis) were obtained in 22 cases. 4 cases of homozygous beta-thalassaemia and 2 of sickle-cell anaemia were diagnosed. The difference between the homozygous and non-homozygous states was well defined. Fetal bleeding from cord puncture and amnionitis resulted in the loss of three fetuses, and methods to avoid these complications are being devised. It is concluded that prenatal diagnosis of disorders of beta-globin synthesis is feasible.

Anemia, Sickle Cell↗