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Biomedical subjects

G Schemmer

Publications and source records attributed to G Schemmer.

5 recordsLinked to original sources

Cervical wet mount as a negative predictor for gonococci- and Chlamydia trachomatis-induced cervicitis in a gravid population.

OBJECTIVE: The purpose of this study was to determine whether a wet mount preparation of endocervical secretions from obstetric patients can accurately rule out the presence of gonococci and Chlamydia trachomatis. STUDY DESIGN: Gravid patients were screened for gonococci and C trachomatis with a deoxyribonucleic acid probe and a wet mount preparation of endocervical secretions. The number of polymorphonuclear lymphocytes was counted and averaged per x400 high-power field. A count of <10 polymorphonuclear lymphocytes per high-power field was defined as predicting the absence of gonococci- and C trachomatis -induced cervicitis. A chi(2) analysis was used to compare the wet mount results to the deoxyribonucleic acid probe. RESULTS: Between January and March 1998, 341 patients were enrolled in the study. Wet mount results showed 32% (108/341) of patients had <10 polymorphonuclear lymphocytes per high-power field. The incidence of infection with gonococci and C trachomatis in this population, as determined by deoxyribonucleic acid probe, was 10 of 341 (2.9%) and 30 of 340 (8.8%), respectively. The sensitivity values for gonococci and C trachomatis were 90% and 87%, respectively. The negative predictive value of the wet mount for gonococci-induced cervicitis was 99%, and that for C trachomatis -induced cervicitis was 96%. CONCLUSION: In this population the wet mount accurately predicted the absence of gonococci- and C trachomatis -induced cervicitis. Use of this screening protocol in gravid patients has the potential to reduce the cost of screening for these 2 diseases.

Adult↗

First-trimester growth patterns of aneuploid fetuses.

First-trimester growth restriction has been reported in certain aneuploid pregnancies. The purpose of this study was to evaluate this association further by comparing the crown-rump lengths (CRLs) and growth rates from 196 chromosomally abnormal fetuses with a control population of 1929 euploid fetuses. The mean CRLs and growth rates were significantly reduced (P < 0.05) in the groups of fetuses with trisomy 18 (n = 49), trisomy 13 (n = 19), and triploidy (n = 8). Using a fifth percentile cut-off, growth rate was a better discriminator than a single CRL in identifying fetuses affected with these aneuploidies. These growth parameters were not significantly reduced in fetuses with trisomy 21 (n = 92), sex chromosome trisomies (n = 20), or 45,X (n = 8). We conclude that fetal growth restriction associated with an underlying chromosome abnormality can occur as early as the first trimester. This phenomenon results from intrinsic fetal factors and not delayed ovulation. Such information is important to establish as first-trimester serum screening evolves.

Aneuploidy↗

Anti-p57: a novel association with neonatal lupus.

IgG antibodies to a 57-kD protein (p57) present in various human and bovine extracts were detected by immunoblotting in the serum of the mother of a baby with congenital heart block, but not in the corresponding cord blood, suggesting specific antibody consumption in the baby. Since this indicates a possible functional role for these antibodies, the antigen target was characterized and the association of the antibodies to heart block was further studied. A human K562 lambda gt11 cDNA library was screened and two clones were identified whose products reacted with the prototype serum. Antibody affinity-purified by use of the cloned gene products reacted on immunoblot with the 57-kD band. Partial sequences of both inserts were identical, but differed from DNA encoding the Ro(SSA) and La(SSB) antigens. Antibodies to the p57 were detected in 10% of systemic lupus erythematosus (SLE) sera, almost exclusively in association with anti-Ro(SSA). Furthermore, they were present in 38% (8/21) mothers of babies with neonatal lupus expressing either cardiac or cutaneous manifestations. Antibodies to this 57-kD protein may be an additional risk factor for neonatal lupus in anti-Ro-positive women. Moreover, disappearance of antibody from cord blood suggests that they may have a role in disease manifestations.

Autoantibodies↗

Multifetal reduction of triplets to twins improves perinatal outcome.

OBJECTIVE: Our purpose was to compare the perinatal outcome of triplet pregnancies reduced to twins with the outcomes of continuing triplet pregnancies and twin pregnancies. STUDY DESIGN: Pregnancy outcomes of triplet pregnancies reduced to twins delivered between July 1988 and July 1992 were compared with pregnancy outcomes of continuing triplet and twin pregnancies delivered over the same time period. RESULTS: The mean gestational age at delivery for the reduced triplets was 35.6 weeks, compared with 31.2 weeks in the nonreduced triplets (p = 0.002). The perinatal mortality rate was 30 per 1000 births in the reduction group and 210 per 1000 births in the nonreduced triplets (p < 0.0001). There were no statistically significant differences between the reduced and nonreduced twins. CONCLUSION: Multifetal pregnancy reduction of triplets to twins yields an improved perinatal outcome compared with nonreduced triplets and a similar outcome compared with nonreduced twins.

Abortion, Therapeutic↗

Genetic amniocentesis and chorionic villus sampling.

With the expanding list of prenatally detectable disorders, increasing numbers of patients are presented with the option of invasive prenatal diagnosis. Care providers need to address questions regarding the safety and accuracy of these procedures, as well as the indication. This article reviews these issues for genetic amniocentesis and chorionic villus sampling.

Amniocentesis↗