Amniocentesis Safer For Pregnant Women, New Study
Finds
Main Category: Pregnancy News
Article Date: 05 Nov 2006 - 0:00 PST
Amniocentesis is the most commonly prescribed invasive test performed
during pregnancies in the United States. Most women fear them while
doctors recommend them based on guidelines from the American College
of Obstetricians and Gynecologists. These guidelines stem from past
research studies and recommendations by the CDC that were based
only on maternal age. Studies that are decades old have suggested
that amniocentesis increases the rate of miscarriage by 0.5% or
1 in 200 pregnancies. However, researchers at Mount School of Medicine
in conjunction with other institutions involved in the First and
Second Trimester Evaluation of Risk for Aneuploidy trial (FASTER
trial) have just reported in the November issue of the journal Obstetrics
& Gynecology, that pregnancy miscarriage rates after routine
midtrimester amniocentesis are significantly lower than rates previously
published years ago in the 1970s and 1980s. This study reports that
the amniocentesis procedure- related loss risk is approximately
1 in 1,600 pregnancies.
Lead author of the study, "Pregnancy Loss Rates After Midtrimester
Amniocentis", Dr. Keith E. Eddleman, MD, Associate Professor
of Obstetrics, Gynecology and Reproductive Sciences at Mount Sinai
School of Medicine has found that this new study now refutes the
typically quoted 0.5% pregnancy loss rate and suggests it may be
even lower than 0.1%."Women should be counseled that this older
loss rate is archaic and their decision about whether or not to
have an amniocentesis should be based on contemporary information
about miscarriage rates with newer screening techniques, rather
than just relying on general age based risks," said Eddleman.
"This new research breakthrough will have a significant effect
on how women are counseled about amniocentesis by their doctors
and the information they have when deciding about screening for
their unborn child."
One of the purposes of the FASTER trial was to calculate the contemporary
procedure-related loss rate after midtrimester amniocentesis using
patients who were recruited for aneuploidy screening. A total of
35,003 unselected patients were enrolled between 10 3/7 and 13 6/7
weeks of pregnancy and followed until the end of pregnancy. Two
groups were derived- those who did or did not undergo amniocentesis.
The rate of fetal loss was compared between these groups and the
fetal loss rate less than 6 months of gestation was 1.0% and was
not statistically different from the control group.
According to researchers, the procedure related loss rate after
amniocentesis was 0.06%. Women undergoing amniocentesis were only
1.1 times more likely to have a spontaneous loss. Researchers concluded
that the procedure related loss rate after midtrimester amniocentesis
performed on patients in a contemporary clinical trial was 0.06%.
There was no significant difference in loss rates between those
undergoing amniocentesis and those not undergoing amniocentesis.
Aneuploidy is a chromosomal imbalance of one or a few chromosomes
above or below the normal human chromosomal number of 46, which
may lead a child to have abnormalities including Down Syndrome.
Amniocentesis is the standard prenatal detection procedure for aneuploidy.
It has been a standard clinical practice to test women using this
procedure who are 35 years or older as well as women who are genetically
predisposed for certain disorders.
###
MOUNT SINAI SCHOOL OF MEDICINE
Located in Manhattan, Mount Sinai School of Medicine is internationally
recognized for ground-breaking clinical and basic-science research,
and innovative approaches to medical education. Through the Mount
Sinai Graduate School of Biological Sciences, Mount Sinai trains
biomedical researchers with an emphasis on the rapid translation
of discoveries of basic research into new techniques for fighting
disease. One indication of Mount Sinai's leadership in scientific
investigation is its receipt during fiscal year 2005 of $252.2 million.
Mount Sinai now ranks 20th among the nation's medical schools in
receipt of research support from NIH. Mount Sinai School of Medicine
also is known for unique educational programs such as the Humanities
in Medicine program, which creates opportunities for liberal arts
students to pursue medical school, and instructional innovations
like The Morchand Center, the nation's largest program teaching
students and physicians with "standardized patients" to
become not only highly skilled, but compassionate caregivers. Long
dedicated to improving its community, the School extends its boundaries
to work with East Harlem and surrounding communities to provide
access to health care and educational programs to at risk populations.
FASTER Research Consortium:
Mount Sinai School of Medicine, Columbia University, University
of Utah and IHC Perinatal Centers, Swedish Medical Center, Seattle
WA, William Beaumont Medical Center, MI, University of Texas Medical
Branch, Montefiore Medical Center, University of Colorado Health
Science Center, New York University Medical Center, Tufts University,
Brown University, University of North Carolina, Chapel Hill, National
Institute of Child Health and Human Development, DM-STAT, Inc.
Contact: Mount Sinai Press Office
The Mount Sinai Hospital / Mount Sinai School of Medicine
Amniocentesis replaced by simple blood test for
pregnant mothers
Main Category: Cancer / Oncology News
Article Date: 03 Mar 2004 - 0:00 PST
A simple blood test could replace invasive tests such as amniocentesis
for pregnant women, according to a new study.
The researchers in this new study detected fragments of the fetus's
DNA in the mother's blood. This will allow scientists to develop
tests for Down Syndrome, Cystic Fibrosis and Sickle Cell Disease.
They also said this research could help develop tests which identify
DNA fragments that come off cancer cells. Doctors would then know
how and whether a cancer is progressing.
Women over the age of 35 and women who have other risk factors
are generally advised to have amniocentesis when they are pregnant.
This is an invasive procedure. The doctor sticks a needle into the
uterus, he then extracts fetal (foetal in the UK) cells from the
amniotic fluid (fluid around the fetus). Amniocentesis can cause
miscarriages - one in two hundred chance.
There are blood tests which detect proteins and other substances
in the blood of the mother. However, they are not as accurate as
amniocentesis or Chorionic Villus Sampling (CVS - which removes
fetal cells from the placenta).
Until now, it has been impossible to trace fetal DNA in the mother's
bloodstream. This is because there is too much free floating DNA
from the mother.
In this new study, researchers managed to reduce the quantity of
maternal DNA fragments. They also managed to increase the percentage
of fetal DNA. The researchers are from Ravgen Inc., Md., (USA).
They treated the mother's blood with formaldehyde. This hardened
the maternal blood cells. This in turn made the maternal cells less
likely to burst and shed so many DNA fragments.
This boosted the fetal percentage in the blood from 7.7% to 20.2%
(of DNA fragments).
According to Dr. Ravinder Dhallan, President of Ravgen 'this is
the first and most important step."
They said it will be about five years before prenatal DNA blood
tests are available to the general public.
Deaths due to falls rising in the elderly
Last Updated: 2006-11-16 15:14:12 -0400
(Reuters Health)
NEW YORK (Reuters Health) - Between 1993 and 2003, the
rate of fatal falls increased significantly for people age 65 and
older, investigators at the Centers for Disease Control and Prevention
report. During that same period, the rate of hospitalization for
fall-related hip fractures decreased, while that for overall non-fatal
injuries remained fairly stable.
Falls in the elderly are common and can lead to death, disability,
nursing home admission, and direct medical costs. However, there
are measures that seniors and their families can take to reduce
the risk of falls.
To analyze trends in falls and their consequences, Dr. J. A. Stevens
and colleagues reviewed statistics between 1993 and 2003 and from
2001 to 2005. Data were derived from the Vital Statistics of the
United States, death certificates, the National Hospital Discharge
Survey, and the National Electronic Injury Surveillance System-All
Injury Program.
According to the findings in the CDC's Morbidity and Mortality
Weekly Report, the age-adjusted rate of fatal falls rose from 23.7
to 38.8 per 100,000 people during the 10-year study period, a 55.3
percent increase. Although rates of change tended to be higher among
women, men had more fatal falls throughout that period. For example,
in 2003, the rates per 100,000 were 46.2 for men and 32.8 for women.
Between 1993 and 1996, the rate of hospitalization for hip fracture
rose, then dipped, for an overall decrease of 15.5 percent.
Stevens' group points out that one reason for the rise in fatal
falls may be partially due to seniors' greater longevity. However,
more are living with chronic disease that puts them at increased
risk for falling and for dying from injures sustained during a fall.
In response to these trends, the CDC and partners have created
posters and brochures outlining ways that seniors can reduce their
risk of falling. These include getting regular exercise, having
medications reviewed to reduce their side effects and interactions,
having yearly eye examinations, and reducing fall hazards in the
home.
SOURCE: Morbidity and Mortality Weekly Report, November
17, 2006.
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