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Dissection of overlapping functions within the adenovirus type 5 E1A gene.

The adenovirus E1A gene encodes multiple, overlapping mRNAs whose products function both to regulate mRNA levels during the lytic cycle of the virus and to facilitate transformation of non-permissive cells. To assign specific functions to the E1A gene products, two adenovirus type 5 variants have been constructed. Mutants dl347 and 348 carry cloned segments corresponding to the E1A 12 and 13S mRNAs, respectively, in place of the normal E1A gene. The variants produced the predicted E1A-specific mRNAs and polypeptides. Both viruses grew efficiently in HeLa cells. Although the 13S mRNA products were more effective, the products of either mRNA species could stimulate the accumulation of mRNAs from additional transcription units. Both viruses could induce the formation of transformed foci in an established rat cell line. Neither virus could transform primary rat embryo cells at normal frequency, and the dl347 foci which were induced were incomplete or abortive transformants. Thus, functions encoded by both 12S and 13S mRNAs are required for efficient and complete transformation of primary rat cells.

Adenoviridae↗

The role of Seprafilm bioresorbable membrane in the prevention and therapy of endometrial synechiae.

This randomized controlled blind prospective study is undertaken to evaluate the safety and efficacy of Seprafilm--a novel bioresorbable membrane of chemically modified hyaluronic acid and carboxymethylcellulose--in prevention and reduction of postoperative endometrial and endocervical synechiae formation after general suction evacuation or curettage for incomplete, missed, and recurrent abortion. In total, 150 patients with incomplete or missed abortion participated in the clinical study. The study population was divided into two main groups. In the treatment (Seprafilm) group (n=50), application of Seprafilm membrane in the endometrial cavity and the cervical canal was used after the suction evacuation and/or the curettage. In the control group (n=100), nothing was inserted in the uterus. Both groups were divided into two subgroups: patients who had no previous suction or curettage, (with no previous D&C) (n=88), and patients who had at least one previous suction or curettage (with one or more previous D&C) (n=62). In the treatment (Seprafilm) group, 32 patients had no previous D&C and 18 patients had one or more previous D&C. In the control group, 56 patients had no previous D&C and 44 patients had one or more previous D&C. Further fertility was estimated by pregnancy success in all groups. Endometrial synechiae formation was evaluated with the use of hysterosalpingography (HSG) in patients of all groups without pregnancy success 8 months after the intervention. Registering any adverse reaction and performing ultrasound controls assessed the safety of Seprafilm use. From the subgroup with no previous D&C, all 32 patients (100%) who received Seprafilm had a pregnancy in the following 8 months; in the controls, pregnancy occurred only in 54%. It was also demonstrated with hysterosalpingography (HSG) that patients with one or more previous interventions and no pregnancy 8 months later were adhesion free in 90% of the patients where Seprafilm was used, and only 50% in the untreated group. The membrane was tested on the endometrial area of the uterus and did not produce any adverse reaction. Ultrasound controls did not show any abnormal echoes. Intrauterine insertion of Seprafilm is safe, prevents the appearance of endocervical adhesions or endometrial synechiae after curettage, and reduces the area of the endometrial cavity occupied by them in a large percent of cases. It also seems that its use improves the possibility of a new pregnancy and fertility.

Abortion, Habitual↗

Fetal limb constriction: a possible complication of CVS.

A case of fetal loss due to infection after first-trimester chorionic villus sampling is described. The fetus was born at 18 3/7 weeks and showed an annular constriction of one of the arms as seen in the amniotic band sequence. Induction of congenital defects might be one of the complications of chorionic villus sampling.

Abortion, Incomplete↗

Severe fetal cytomegalovirus infection associated with cerebellar hemorrhage.

Cytomegalovirus (CMV) is the most common cause of congenital infection worldwide. We report on a fatal fetal manifestation of primary maternal CMV infection including cerebellar hemorrhage and hydrops. The diagnosis was established by maternal serological tests, culture and polymerase chain reaction testing of amniotic fluid and fetal blood. The pregnancy was terminated. Postmortem examination confirmed the diagnosis.

Abortion, Incomplete↗

Transvaginal ultrasound after first-trimester uterine evacuation reduces the incidence of retained products of conception.

OBJECTIVE: To assess the incidence of retained products of conception (RPOC) in relation to transvaginal ultrasound performed after first-trimester uterine evacuation. METHODS: This was a prospective randomized study involving 809 women undergoing first-trimester uterine evacuation. The study group included 404 women in whom transvaginal sonography was performed at the end of the surgical procedure and the control group contained 405 women who did not undergo ultrasound examination. Initially, in the study group, recurettage was immediately performed if the endometrium appeared irregular but latterly only if endometrial thickness was > or = 8 mm. The patients were followed up by gynecological and ultrasound examinations 5-8 days following the surgical procedure. RESULTS: The total complication rate was 4.3%. RPOC presented in three women in the study group (0.7%) and in 15 women in the control group (3.7%, P < 0.05). Vaginal bleeding requiring hospitalization occurred in two women in the study group (0.5%) vs. seven in the control group (1.7%, P = 0.2). Endometritis was diagnosed in one woman in the study group (0.2%) vs. six in the control group (1.5%) and uterine perforation occurred in one woman in the control group vs. none in the study group. There were no cases of RPOC in women who had an endometrial thickness of < 8 mm as demonstrated by ultrasound at the end of the surgical procedure. CONCLUSION: Transvaginal sonography immediately following first-trimester uterine evacuation may reduce the incidence of RPOC and the total complication rate. When the endometrial thickness is > or = 8 mm at the end of suction curettage, an attempt at re-evacuation of the uterine cavity is indicated.

Abortion, Incomplete↗

[Chorion biopsy--a new method of prenatal diagnosis].

Chorionic villi are derivates of the trophoectoderm and therefore have the same genetic constitution as the embryo. The recently developed techniques of chorionic villi sampling in the 9th to 11th week of pregnancy and the cytogenetic analysis of this material open a new field in the prenatal diagnosis of chromosomal aberrations. With this method, a result is obtained about 8 weeks earlier than with the classical procedures performed by amniocentesis. This offers major advantages to both patient and physician.

Abortion, Incomplete↗

Very early pregnancy wastage in in vitro fertilization and embryo transfer (IVF-ET).

The occurrence and incidence of early pregnancy wastage in an in vitro fertilization and embryo transfer (IVF-ET) program have been studied in 750 patients. In 297 (39.6%) a pregnancy was diagnosed; of these, 14.8% were biochemical and 24.8% clinical pregnancies. In the latter group 23.6% aborted, while 75.8% had clinical ongoing pregnancies. The mean embryo quality score of the biochemical pregnancy group was similar to that of the clinical ongoing pregnancy group but statistically different from that of the clinical abortion group (P less than 0.005). Furthermore, the clinical ongoing pregnancy rate in women with previous biochemical pregnancy was 24.7%, a significantly higher percentage compared to clinical ongoing pregnancies achieved in IVF-ET cycles (P less than 0.05). It is possible that biochemical pregnancy does not represent an index for infertility but rather an intact stage of reproduction leading toward implantation. The high clinical pregnancy rate in subsequent cycles may probably serve as an encouraging sign or a marker for future clinical pregnancy.

Abortion, Incomplete↗

Maternal phenylketonuria--the Irish experience.

The outcome of 48 pregnancies in 18 women with elevated phenylalanine was studied. The women were divided into two groups, diet and non-diet. All the women on diet had severe hyperphenylalaninaemia and only six were on the amino acid mixture at conception. In the non-diet group four women had concentrations of less than 1000 mumols/L and five had severe hyperphenylalaninaemia. Three deaths and one stillbirth occurred in the non-diet group. Microcephaly occurred in 24 children; 11 in the diet group and 13 in the non-diet group. There were five miscarriages in the non-diet group and one in the diet group. Diet is beneficial when started early but planned pregnancies, good motivation and compliance were difficult to achieve in this group of women despite every reasonable effort by the PKU clinic.

Abortion, Incomplete↗

Cryptophthalmos.

Cryptophthalmos, a very rare congenital anomaly of the eye, is characterised by skin passing continuously from the forehead to the cheek over a malformed eye. It may be isolated or more commonly as a part of Fraser syndrome. Cryptophthalmos is classified into three types: complete, incomplete and abortive. Surgical reconstruction is the modality of treatment available. We present a case of bilateral, complete, isolated cryptophthalmos, who has undergone stage 1 of reconstructive surgery.

Eye Abnormalities↗

A survey of uterine perforation following dilatation and curettage or evacuation of retained products of conception.

STUDY: Of 11,914 women who underwent dilatation and curettage over a 7-year period (1995-2002) at Princess Badea Teaching Hospital in Irbid, North Jordan, 23 patients sustained a uterine perforation. In 22 cases, the operator was a trainee. Previous gynaecological surgery had been performed in only 2 of these 23 women. CONCLUSION: Operator inexperience seemed to be the only risk factor in this very common operation.

Abortion, Incomplete↗

Chromosomes and the gynecologist.

Recent advances in cytogenetic techniques made a valuable contribution toward the modern practice of obstetrics and gynecology. The state of the art regarding the application of these techniques is reviewed in the following areas: the clinical features related to the various sex and autosomal chromosomal anomalies, the cytogenetics of gynecologic malignancies, the chromosomal analysis of spontaneous abortion and of parents with habitual abortions. Chromosome studies in male infertility revealed abnormalities in 11.5 per cent of 69 patients with azoospermia and 9.1 per cent of 165 patients with oligospermia. Among 77 patients with primary amenorrhea, 27.3 per cent revealed chromosomal abnormalities compared to 3.8 per cent in 103 patients with secondary amenorrhea. The term "ovotesticular dysgenesis" is used for the first time in the literature to describe a specific histologic type of streak gonad which contains ovarian stroma and dysgenetic testicular tubules.

Abortion, Habitual↗

Genetic amniocentesis: impact of placental position upon the risk of pregnancy loss.

Although it is generally believed that a transplacental tap increases the risk of pregnancy loss associated with genetic amniocentesis, objective data are lacking. To quantitate the risk of transplacental amniocentesis, pregnancy outcomes were compared in 998 consecutive patients in whom amniocentesis was performed under direct real-time sonographic guidance. This technique allows visualization of the path of the needle during insertion and documents with certainty whether the placenta has been traversed. A transplacental approach was necessary in 347 patients (35%). The incidence of spontaneous abortion, antepartum stillbirth, prematurity (less than 37 weeks), and low birth weight (less than 2500 grams) was identical in patients undergoing both transplacental and nontransplacental amniocenteses. The similar rates of pregnancy loss in these two groups indicate that when midtrimester transplacental amniocentesis is ultrasonically guided, it is associated with little if any increased risk.

Abortion, Incomplete↗

Analysis of the human fetal skeleton and organs with xeroradiography.

We have used xeroradiography to study normal and abnormal fetuses including some with anencephaly, hydrocephalus, spina bifida, osteogenesis imperfecta (type IV), Jeune syndrome, radial aplasia, thanatophoric dysplasia, and Pena-Shokeir syndrome. Xeroradiography images the lines of ossification and epiphyses in great detail, shows ossification, and reveals abnormalities that alter bone modeling as seen in Jeune syndrome, osteogenesis imperfecta (type IV), and thanatophoric dysplasia. This technique can be used successfully to examine soft tissues and organs. It can also be used in combination with contrast materials to identify the lateral ventricles, the cardiovascular, gastrointestinal, urinary, and respiratory systems, and the cavities (pleural and peritoneal) of the fetal body.

Abortion, Incomplete↗

The effects of maternal exercise on early pregnancy outcome.

This study was designed to test the hypothesis that vigorous aerobic exercise during both the periconceptional period and early pregnancy increases the incidence of abnormal early pregnancy outcome. Exercise performance was prospectively monitored before and during pregnancy in 47 recreational runners, 40 aerobic dancers, and 28 physically active, fit controls. Pregnancy was diagnosed by an early test for beta-subunit human chorionic gonadotropin and viability was confirmed by ultrasonography at 40 days' conceptional age. Spontaneous abortion occurred in 19% of the pregnancies. The incidence was 17% in the runners, 18% in the aerobic dancers, and 25% in the controls. At term, one congenital abnormality was detected in each of the three groups. Late pregnancy events, potentially related to abnormalities of placentation, were limited to two cases of mild pregnancy-induced hypertension. We conclude that, in physically fit women, continuation of these types of aerobic activity at intensities between 50% and 85% of maximum during the periconceptional period and early pregnancy does not appreciably alter early pregnancy outcome.

Abortion, Incomplete↗

The effect of the intrauterine contraceptive device on the prevalence of morphologic abnormalities in human spontaneous abortions.

Spontaneously aborted conceptuses from IUD-wearing patients and prior IUD users were examined pathologically to determine the prevalence of morphologic abnormalities, which had previously been shown to correlate with cytogenetically proven heteroploidy in the conceptus. These abnormalities were never seen in the IUD-associated abortuses while occurring with the same frequency in abortuses obtained from prior IUD users and from non-users. It is concluded that the IUD by itself is responsible for the absence of heteroploidy-correlated structural abnormalities in spontaneous abortuses conceived with the IUD in situ. Relevant mechanisms underlying this IUD effect are discussed.

Abortion, Incomplete↗