Biomedical subjects

Elzbieta Baś-Budecka

Publications and source records attributed to Elzbieta Baś-Budecka.

7 recordsLinked to original sources

PubMed2006

Ultrasound diagnostic schema for the determination of increased risk for chromosomal fetal aneuploidies in the first half of pregnancy.

The aim of the study was to develop an early ultrasound diagnostic schema for the determination of increased risk for fetal chromosomal aneuploidies. The study was conducted on a population of 1318 pregnant women divided into 2 groups: 1255 women with the normal course of pregnancy and 63 women with diagnosed fetal abnormalities. There were 34 cases of chromosomal abnormalities (trisomy 21, 18, 13; triploidy; unbalanced inversion 9; deletion 16) and 29 cases of structural malformations. The estimation of the range of normal values was performed for the nuchal translucency (NT) measurement between 11 and 13 weeks and the nasal bone length (NB) measurement between 12 and 20 week. The results obtained in the collective set of normal pregnancies constituted the basis for the calculation of the range of normal values. The measurements of NB and NT showed a linear value increase with the pregnancy course. The following test characteristics (correlation to CRL) were recorded: NB - sensitivity 60%, specificity 98%, positive predictive value (PPV+) 43%, negative predictive value (NPV-) 98.9%. For the assumption that the test outcome means the presence or absence of the nasal bone in the ultrasound scan the sensitivity was 40%, but specificity 100%; NT - sensitivity 63.6%, specificity 98.2%, PPV+ 38.9%, NPV - 98.2%; NT + NB - presents similar characteristic to the NB or NT alone - sensitivity 55.6%, specificity 98.6%, PPV+ 50%, NPV - 98.9%. The following test characteristics for chromosomal aberration markers (correlation to BPD) were observed: NB - sensitivity 68.4%, specificity 97.4%, PPV+ 56.5%, NPV - 98.4%; NT - sensitivity 73.9%, specificity 97.9%, PPV+ 54.8%, NPV- 99.2%; NT + NB - sensitivity 94.7%, specificity 98.9%, PPV+ 90%, NPV - 99.7%, respectively. The "genetic sonogram" protocol for the structural defect detection was analysed: sensitivity was 80%, specificity 100%, PPV+ 100%, NPV - 99.7%. It is concluded that the new biometric parameter--nasal bone length (NB) and the corrected one--nuchal translucency thickness (NT) are useful markers for fetal abnormalities, especially for chromosomal aberrations. High predictive values of the diagnostic schema for the detection of aneuploidies and structural defects indicate that its application in correlation with the biparietal diameter (BPD) is highly recommended. The proposed schema is an effective algorithm for prenatal diagnostics characterised by high prognostic values. The possible introduction of the schema could result in a decrease of the invasive procedure rates, which could minimise the rate of miscarriages as a complication of amniocenteses.

Adolescent↗

PubMed2006

[Monoamnotic twin pregnancy. Multicenter study].

OBJECTIVE: The purpose of this study was to evaluate of perinatal mortality and morbidity of monoamniotic twins. STUDY DESIGN: This was a multicenter retrospective analysis of 26 monoamniotic twin gestations identified between 1985 and 2004 in a 3 perinatal departments. Of these 26 pregnancies, 11 women were admitted electively for inpatient fetal monitoring. Overall mortality rates, the risk of intrauterine fetal death and neonatal mortality and morbidity, pregnancy complications and fetal anomalies were calculated. RESULTS: Monoamniotic twin pregnancies were diagnosed reliably prenatally by ultrasound in 22 women and at delivery in 4 cases. Of the 26 gestations, spontaneous fetal losses before 22 weeks of gestation were 4 cases. The overall loss rate and the perinatal mortality rate were 52% and 19.4%, respectively. Twenty-two women had both twins alive at 24 weeks of gestation; 11 women were admitted electively for inpatient fetal monitoring at 26-27 week of gestation. In this group there were 2 neonatal deaths. No intrauterine fetal death occurred in any hospitalized patient. In our series there were 100% incidence of prematurity, 38,5% of umbilical cord entaglement, 23% of TTTS, 3.6% of TRAP and 9.6% fetal congenital anomalies. CONCLUSION: Monoamniotic twins are at extremly risk of pregnancy complications and fetal loss. These pregnancies can be diagnosed reliably by ultrasound in most cases. Electively admitted women for inpatient fetal monitoring could be improved neonatal survival and decreased perinatal morbidity.

Congenital Abnormalities↗

PubMed2004

[Nuchal translucency measurement--non invasive ultrasound screening for fetal abnormalities. Part I].

OBJECTIVE: Fetal abnormalities are the most common cause of perinatal and postnatal death and infant handicap. In the last years came into being many diagnostic methods making possible--precise and accurate diagnosis of fetal malformation. DESIGN: Estimation the value of the screening test for fetal abnormalities based on the nuchal translucency measurement between 10-14th week of pregnancy. MATERIAL AND METHODS: A group of 675 women with singleton pregnancies undergoing first trimester nuchal translucency measurement. Nuchal translucency thickness was measured by transvaginal ultrasound examination according to Nicolaides. Derived risks were then calculated. RESULTS: When we used a risk of 1:250 as the cutoff to define a positive result on the screening test, the rate of detection of fetal abnormalities was 100%, with a false positive rate of 1.3%. CONCLUSION: First trimester nuchal translucency measurement is an effective method of screening for fetal abnormalities (obstetrical high-risk group).

Adult↗

PubMed2004

[Nuchal translucency measurement--non invasive ultrasound screening for fetal abnormalities. Part II].

OBJECTIVE: There is well established association between increased nuchal translucency and chromosomal abnormality. DESIGN: To investigate a new method of screening for fetal abnormalities on the basis of maternal age and fetal nuchal translucency thickness in the first and second term of pregnancy. METHODS: A group of 650 pregnant women from the 10th week of pregnancy until childbirth has been put under examination. Nuchal translucency thickness was measured by transvaginal ultrasound examination according to Nicolaides in the first trimester of pregnancy and by transabdominal ultrasound examination between 15-19th week of pregnancy. Derived risk were then calculated. RESULTS: There were 8 chromosomal and 1 structural defects. When we used a risk of 1:250 as the cutoff to define a positive result on the screening test, the rate of detection of fetal abnormalities was 100%, with a false positive rate 0.7%. CONCLUSION: This study suggests a benefit in combining maternal age-related risk together with NT measurement in the first and second trimester of pregnancy. Such kind of test could also be helpful in twin pregnancies.

Adult↗

PubMed2004

[Combination of screening tests for fetal abnormalities in the first and second pregnancy trimesters].

OBJECTIVE: Screening for fetal abnormalities in the second trimester of pregnancy, based on the concentrations of various markers in serum and maternal age, has become widely used in the past decade. In the first trimester fetal malformations are associated with high values for fetal NT. DESIGN: We propose a new screening method in which measurements obtained during both trimesters are integrated to provide a single estimate of a woman's risk of having a pregnancy affected by genetic syndrome. MATERIAL AND METHODS: Study groups comprised 775 pregnant women where examinations were done between 11th-14th and 15th-19th pregnancy weeks. Nuchal translucency thickness was measured by ultrasound examination in both trimesters of pregnancy. AFP, -HCG and oestriol were measured by ELISA assays. Derived risks were then calculated. RESULTS: Eight fetal aneuploidies were diagnosed. When we used a risk of 1:250 as the cutoff to define a positive result on the integrated test, the rate of detection of fetal abnormalities was 100%, with a false positive rate of 0.6%. CONCLUSION: Integrated test, which is a combination of the ultrasound examination and the triple test allows to achieve high sensitivity and the decrease in the percentage of false positive results, which leads to the reduction in the number of amniocentesis to be performed.

Adult↗

PubMed2003

[Ductus venosus blood flow in normal pregnancy outcome].

OBJECTIVE: Doppler studies of the fetal circulation have demonstrated the importance of ductus venosus velocimetry in the monitoring abnormal course of pregnancy. DESIGN: Estimation of the ductus venosus Doppler reference ranges between 10-19th week of pregnancy. MATERIAL AND METHODS: The ductus venosus blood flow has been studied in 140 consecutive fetuses between 10 and 19 week of pregnancy. When a midsagittal view of the fetus was obtained, color Doppler was used to visualize the ductus venosus. The pulsed Doppler sample volume was then placed on it, in the isthmic portion. RESULTS: The mean PIV ranged from 1.09 in the first trimester of pregnancy to 0.96 in the second trimester. CONCLUSION: A decrease in mean PIV values was observed in the course of pregnancy. In the normal course of pregnancy A-wave was observed.

Adult↗

PubMed2003

[Diagnostic methods for fetal malformations in the first half of pregnancy].

INTRODUCTION: Fetal abnormalities are the most common cause of perinatal and postnatal death and infant handicap. For this reason prenatal screening (for fetal malformation) has become a routine part of obstetric care in many countries. Most often used are biochemical tests and continuously developing ultrasound diagnostics which makes possible precise analysis of the fetal morphology. There is interesting to establish a noninvasive test for the early detection of fetal malformation in pregnancy which is based on ultrasound examination (NT measurement from the 10th to the 19th weeks, presence of nasal bone in the first trimester ultrasound), correlated with serum concentration of AFP, beta-HCG and oestriol in the second trimester of pregnancy (triple test). The main aim of the study was to establish a diagnostic schema for detection of fetal malformations based on NT measurement in the first and second trimester coupled with triple test performed in the second trimester. MATERIALS AND METHODS: A group of 775 pregnant women from the 10-th week of pregnancy until childbirth has been put under examination. Between the 10th and the 14th and than between 15th and 19th week of pregnancy ultrasound examination with fetal biometry and NT measurement was done. NT measurements have been performed in accordance with the standards worked out by professor K. Nicolaides. At the first ultrasound examination the presence of the nasal bone was observed. The next step was performing the triple test between the 15th and 19th week of pregnancy. On the same day as second ultrasound examination blood was taken to determine the results of the triple test (ELISA method). The obtained results have undergone statistical analysis. RESULTS: The age of women qualified for the examination oscillated between 15 and 45 (over 35 -9.4%). There were 8 fetal malformations recognized all connected with the chromosomal anomalies, namely, 4 Downs syndrome, 2 fetuses with trisomy of the 18th pair of chromosomes and 2 with triploidy. At all physiologic pregnancies nasal bone was seen during first ultrasound examination. The obtained results of nuchal fold measurements and concentrations for the parameters of the triple test have been the basis to calculate medians in the particular weeks of pregnancy. In all the cases of genetic malformations the widening of the nuchal fold above 99 percentile (MoM NT) has been observed. Fetal nasal bone were absent in 62.5% first trimester ultrasound examinations. The risk of the occurrence of a genetic malformation resulting from the mother's age combined with the risk connected with the NT measurements and the results of the triple test for the cut-off point 1:250 (which seems to be the best for this population) gave 100% sensitivity, 0.6% % of false positive results and the positive predictive value of 80%. The above mentioned results are better than the ones which were obtained within the triple test only, where for the previously fixed cut-off point 1:250 sensitivity reached 63%, positive predictive value 25% and 4.4% false positive rate. Performing the so-called integrated test in which the risk of the occurrence of any malformation is estimated on the basis of the NT measurement in the first and the second term of pregnancy seems to be far more useful. CONCLUSIONS: Diagnostic schema for detection of fetal malformations in the first half of pregnancy which is based on ultrasound examination (NT measurement from the 10th to the 19th weeks), correlated with serum concentration of AFP, beta-HCG and oestriol in the second trimester of pregnancy (triple test) is very sensitive and safe method of the prenatal diagnosis leading to significant decrease of the invasive procedures (amniocentesis).

Abnormalities, Multiple↗