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Entezami M, Mustaqqim F, Morris E, Lim ESH, Prada JM, Paramasivam SJ. Effect of Human Activity and Presence on the Behavior of Long-Tailed Macaques ( Macaca fascicularis) in an Urban Tourism Site in Kuala Selangor, Malaysia. Animals (Basel) 2024; 14:1173. [PMID: 38672321 PMCID: PMC11047574 DOI: 10.3390/ani14081173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 04/05/2024] [Accepted: 04/11/2024] [Indexed: 04/28/2024] Open
Abstract
The increasing overlap of resources between human and long-tailed macaque (Macaca fascicularis) (LTM) populations have escalated human-primate conflict. In Malaysia, LTMs are labeled as a 'pest' species due to the macaques' opportunistic nature. This study investigates the activity budget of LTMs in an urban tourism site and how human activities influence it. Observational data were collected from LTMs daily for a period of four months. The observed behaviors were compared across differing levels of human interaction, between different times of day, and between high, medium, and low human traffic zones. LTMs exhibited varying ecological behavior patterns when observed across zones of differing human traffic, e.g., higher inactivity when human presence is high. More concerning is the impact on these animals' welfare and group dynamics as the increase in interactions with humans takes place; we noted increased inactivity and reduced intra-group interaction. This study highlights the connection that LTMs make between human activity and sources of anthropogenic food. Only through understanding LTM interaction can the cause for human-primate conflict be better understood, and thus, more sustainable mitigation strategies can be generated.
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Affiliation(s)
- Mahbod Entezami
- School of Veterinary Medicine, Faculty of Health and Medical Sciences, University of Surrey, Daphne Jackson Road, Guildford GU2 7AL, UK; (M.E.); (E.M.); (J.M.P.)
| | - Fiqri Mustaqqim
- School of Postgraduate Studies, Perdana University, Serdang 43400, Malaysia
| | - Elizabeth Morris
- School of Veterinary Medicine, Faculty of Health and Medical Sciences, University of Surrey, Daphne Jackson Road, Guildford GU2 7AL, UK; (M.E.); (E.M.); (J.M.P.)
| | - Erin Swee Hua Lim
- Abu Dhabi Women’s College, Higher Colleges of Technology, Abu Dhabi 41012, United Arab Emirates;
- Centre for Research Excellence, Perdana University, Serdang 43400, Malaysia
| | - Joaquín M. Prada
- School of Veterinary Medicine, Faculty of Health and Medical Sciences, University of Surrey, Daphne Jackson Road, Guildford GU2 7AL, UK; (M.E.); (E.M.); (J.M.P.)
| | - Sharmini Julita Paramasivam
- School of Veterinary Medicine, Faculty of Health and Medical Sciences, University of Surrey, Daphne Jackson Road, Guildford GU2 7AL, UK; (M.E.); (E.M.); (J.M.P.)
- Animal Neighbours Project, School of Veterinary Medicine, University of Surrey, Daphne Jackson Road, Guildford GU2 7AL, UK
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Borhani M, Mohammadi MA, Entezami M, Baneshi MR, Nasibi S, Prada JM, Fasihi Harandi M. Reinfection of farm dogs following praziquantel treatment in an endemic region of cystic echinococcosis in southeastern Iran. PLoS Negl Trop Dis 2024; 18:e0011939. [PMID: 38536863 PMCID: PMC11020379 DOI: 10.1371/journal.pntd.0011939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 04/16/2024] [Accepted: 01/23/2024] [Indexed: 04/18/2024] Open
Abstract
Cystic Echinococcosis (CE) as a prevalent tapeworm infection of human and herbivorous animals worldwide, is caused by accidental ingestion of Echinococcus granulosus eggs excreted from infected dogs. CE is endemic in the Middle East and North Africa, and is considered as an important parasitic zoonosis in Iran. It is transmitted between dogs as the primary definitive host and different livestock species as the intermediate hosts. One of the most important measures for CE control is dog deworming with praziquantel. Due to the frequent reinfection of dogs, intensive deworming campaigns are critical for breaking CE transmission. Dog reinfection rate could be used as an indicator of the intensity of local CE transmission in endemic areas. However, our knowledge on the extent of reinfection in the endemic regions is poor. The purpose of the present study was to determine E. granulosus reinfection rate after praziquantel administration in a population of owned dogs in Kerman, Iran. A cohort of 150 owned dogs was recruited, with stool samples collected before praziquantel administration as a single oral dose of 5 mg/kg. The re-samplings of the owned dogs were performed at 2, 5 and 12 months following initial praziquantel administration. Stool samples were examined microscopically using Willis flotation method. Genomic DNA was extracted, and E. granulosus sensu lato-specific primers were used to PCR-amplify a 133-bp fragment of a repeat unit of the parasite genome. Survival analysis was performed using Kaplan-Meier method to calculate cumulative survival rates, which is used here to capture reinfection dynamics, and monthly incidence of infection, capturing also the spatial distribution of disease risk. Results of survival analysis showed 8, 12 and 17% total reinfection rates in 2, 5 and 12 months following initial praziquantel administration, respectively, indicating that 92, 88 and 83% of the dogs had no detectable infection in that same time periods. The monthly incidence of reinfection in total owned dog population was estimated at 1.5% (95% CI 1.0-2.1). The results showed that the prevalence of echinococcosis in owned dogs, using copro-PCR assay was 42.6%. However, using conventional microscopy, 8% of fecal samples were positive for taeniid eggs. Our results suggest that regular treatment of the dog population with praziquantel every 60 days is ideal, however the frequency of dog dosing faces major logistics and cost challenges, threatening the sustainability of control programs. Understanding the nature and extent of dog reinfection in the endemic areas is essential for successful implementation of control programs and understanding patterns of CE transmission.
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Affiliation(s)
- Mehdi Borhani
- Research Center for Hydatid Disease in Iran, Kerman University of Medical Sciences, Kerman, Iran
- State Key Laboratory for Zoonotic Diseases, Key Laboratory of Zoonosis Research, Ministry of Education, Institute of Zoonosis, College of Veterinary Medicine, Jilin University, Changchun, China
| | - Mohammad Ali Mohammadi
- Research Center for Hydatid Disease in Iran, Kerman University of Medical Sciences, Kerman, Iran
| | - Mahbod Entezami
- School of Veterinary Medicine, University of Surrey, Guildford, United Kingdom
| | - Mohammad Reza Baneshi
- School of Public Health, The University of Queensland Faculty of Medicine, Herston, Australia
- Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Saeid Nasibi
- Research Center for Hydatid Disease in Iran, Kerman University of Medical Sciences, Kerman, Iran
| | - Joaquin M. Prada
- School of Veterinary Medicine, University of Surrey, Guildford, United Kingdom
| | - Majid Fasihi Harandi
- Research Center for Hydatid Disease in Iran, Kerman University of Medical Sciences, Kerman, Iran
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Entezami M, Nocerino M, Widdicombe J, Bosco A, Cringoli G, Casulli A, Iacono GL, Rinaldi L, Prada JM. The spatial distribution of cystic echinococcosis in Italian ruminant farms from routine surveillance data. Front Trop Dis 2022. [DOI: 10.3389/fitd.2022.1034572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
IntroductionCystic echinococcosis (CE) is a zoonotic parasite caused by the cestode Echinococcus granulosus sensu lato (s.l.) which predominantly affects livestock. The disease is endemic in central-southern and insular Italy, with CE particularly infecting sheep, goats, cattle, and water buffalo. The spatial distribution of CE in endemic regions is not widely understood, with surveillance efforts varying across the region.MethodsIn this study, we investigated the spatial distribution of CE in livestock using samples from farms across different livestock species using a Stochastic Partial Differential Equations (SPDE) model. Samples were collected during a survey conducted in the area of central-southern and insular Italy between the years 2019 – 2021.ResultsA total of 3141 animal samples (126 goats, 601 sheep and 2414 cattle and water buffalo) were inspected for Echinococcus s.l. cysts through routine surveillance in abattoirs by postmortem visual examination, palpation and incision of target organs. The geographic location of the farm of origin (a total of 2,878) for each sample was recorded. CE prevalence of 46.0% (1,323/2,878) was estimated at the farm level with 78.3% (462/590) of farms with sheep, 28.6% (36/126) of farms with goats, 36.5% (747/2,049) of farms with cattle, and 23.5% (102/434) of farms with water buffalo infected.DiscussionThe spatial model evaluated the probability of infection in farms across the sampled regions, with the distribution of CE showing high clustering of infected cattle farms in Sardinia and Sicily regions, and sheep farms in Salerno province (Campania region). The output of this study can be used to identify CE hot-spots and to improve surveillance and control programs in endemic areas of Italy.
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Widdicombe J, Basáñez MG, Entezami M, Jackson D, Larrieu E, Prada JM. The economic evaluation of Cystic echinococcosis control strategies focused on zoonotic hosts: A scoping review. PLoS Negl Trop Dis 2022; 16:e0010568. [PMID: 35797271 PMCID: PMC9262177 DOI: 10.1371/journal.pntd.0010568] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 06/07/2022] [Indexed: 12/29/2022] Open
Abstract
Background Cystic echinococcosis (CE) is a zoonotic neglected tropical disease (zNTD) which imposes considerable financial burden to endemic countries. The 2021–2030 World Health Organization’s roadmap on NTDs has proposed that intensified control be achieved in hyperendemic areas of 17 countries by 2030. Successful interventions for disease control, and the scale-up of programmes applying such interventions, rely on understanding the associated costs and relative return for investment. We conducted a scoping review of existing peer-reviewed literature on economic evaluations of CE control strategies focused on Echinococcus granulosus zoonotic hosts. Methodology/Principal findings Database searches of Scopus, PubMed, Web of Science, CABI Direct and JSTOR were conducted and comprehensively reviewed in March 2022, using predefined search criteria with no date, field or language restrictions. A total of 100 papers were initially identified and assessed for eligibility against strict inclusion and exclusion criteria, following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. Bibliography review of included manuscripts was used to identify additional literature. Full review of the final manuscript selection (n = 9) was performed and cost data for control interventions were extracted. Conclusions/Significance There are very little published data pertaining to the cost and cost effectiveness of CE control interventions targeting its zoonotic hosts. Data given for costs are often incomplete, thus we were unable to perform an economic analysis and cost effectiveness study, highlighting a pressing need for this information. There is much scope for future work in this area. More detailed information and disaggregated costings need to be collected and made available. This would increase the accuracy of any cost-effective analyses to be performed and allow for a greater understanding of the opportunity cost of healthcare decisions and resource allocation by stakeholders and policy makers for effective and cost-effective CE control. Cystic echinococcosis (CE) is a zoonotic neglected tropical disease which predominantly affects poor pastoral communities globally. The parasite cycles between farm dogs and livestock, and is associated with livestock farming and feeding of infected offal to dogs. Although no noticeable clinical signs are seen in livestock, some production losses, such as reduced milk yield and live weight gain may be observed, and offal condemnation at slaughter is common. The disease can also affect people, due to accidental ingestion of parasite eggs on contaminated food and contact with dogs. Human morbidity and mortality occur due to cyst formation in body organs, exerting a substantial health and financial burden to the health sector of affected countries. Control interventions to reduce CE transmission include sheep vaccination and dog deworming. Long-term control programmes are often expensive, and the true costs of such programmes poorly documented. This scoping review aims to examine published literature on the costs of CE control in zoonotic hosts and report detailed costs of individual elements of a control programme, thereby furthering our understanding of the true economic cost of CE control.
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Affiliation(s)
- Jo Widdicombe
- School of Veterinary Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
- * E-mail:
| | - María-Gloria Basáñez
- MRC Centre for Global Infectious Disease Analysis and London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, United Kingdom
| | - Mahbod Entezami
- School of Veterinary Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - Daniel Jackson
- Surrey Health Economics Centre, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - Edmundo Larrieu
- Universidad Nacional de Rio Negro, Choele Choel, Rio Negro, Argentina
| | - Joaquín M. Prada
- School of Veterinary Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
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Chaoui R, Benoit B, Entezami M, Frenzel W, Heling KS, Ladendorf B, Pietzsch V, Sarut Lopez A, Karl K. Ratio of fetal choroid plexus to head size: simple sonographic marker of open spina bifida at 11-13 weeks' gestation. Ultrasound Obstet Gynecol 2020; 55:81-86. [PMID: 31559662 DOI: 10.1002/uog.20856] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 08/13/2019] [Accepted: 08/20/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVES To measure the ratio of choroid plexus (CP) size to head size in normal fetuses and to compare it to that in fetuses with open spina bifida (OSB) and quantify the subjective sign of a 'dry brain'. METHODS This was a retrospective study of ultrasound images, obtained during first-trimester screening between 11 and 13 weeks of gestation, from 34 fetuses with OSB and 160 normal fetuses. From the hospital databases, we retrieved images of the fetal head in the transventricular axial plane. We measured the areas of both CPs and the head and calculated the ratio between them. We also measured the longest diameter of each CP and calculated their mean (CP length), and measured the occipitofrontal diameter (OFD) and calculated the ratio of CP length to OFD. Measurements from the OSB fetuses were plotted on crown-rump length (CRL) reference ranges constructed using data from the normal fetuses, and Z-scores were calculated. RESULTS In the normal fetuses, the CP area increased, while the ratios of CP area to head area and CP length to OFD decreased, with increasing CRL. In 30 of the 34 (88%) fetuses with OSB, both ratios were increased significantly and the CPs filled the entirety of the head, giving the impression of a dry brain. In these cases, the borders of the lateral ventricles could not be identified. CONCLUSIONS At 11-13 weeks, the majority of fetuses with OSB have reduced fluid in the lateral ventricles such that the CPs fill the head. The dry brain sign is easily visualized during routine first-trimester ultrasound examination while measuring the biparietal diameter, and can be quantified by comparing the size of the CPs to the head size. Until prospective data confirm the usefulness of this sign in screening for OSB, it should be considered as a hint to prompt the examiner to assess thoroughly the posterior fossa and spine. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- R Chaoui
- Center for Prenatal Diagnosis and Human Genetics, Berlin, Germany
| | - B Benoit
- Department of Obstetrics and Gynecology, Princess Grace Hospital, Monaco
| | - M Entezami
- Center for Prenatal Diagnosis, Berlin, Germany
| | - W Frenzel
- Center for Prenatal Diagnosis and Human Genetics, Berlin, Germany
| | - K S Heling
- Center for Prenatal Diagnosis and Human Genetics, Berlin, Germany
| | - B Ladendorf
- Center for Prenatal Diagnosis and Human Genetics, Berlin, Germany
| | - V Pietzsch
- Prenatal Diagnosis Clinic, Waiblingen, Germany
| | - A Sarut Lopez
- Center for Prenatal Diagnosis and Human Genetics, Berlin, Germany
| | - K Karl
- Department of Obstetrics and Gynecology, Ludwig-Maximilians University, Munich, Germany
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van Uden L, Seliger G, Bergner M, Entezami M, Tchirikov M. „Long-Tail-Ballon“-FETO Studie zur Behandlung der schweren kongenitalen Zwerchfellhernie (ClinicalTrials.gov: NCT 03431792). Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- L van Uden
- Universitätsklinikum Halle (Saale), Universitätsklinikum und Poliklinik für Geburtshilfe und Pränatalmedizin, Halle (Saale), Deutschland
| | - G Seliger
- Universitätsklinikum Halle (Saale), Universitätsklinikum und Poliklinik für Geburtshilfe und Pränatalmedizin, Halle (Saale), Deutschland
| | - M Bergner
- Universitätsklinikum Halle (Saale), Universitätsklinikum und Poliklinik für Geburtshilfe und Pränatalmedizin, Halle (Saale), Deutschland
| | - M Entezami
- Zentrum für Pränataldiagnostik und Humangenetik, Berlin, Deutschland
| | - M Tchirikov
- Universitätsklinikum Halle (Saale), Universitätsklinikum und Poliklinik für Geburtshilfe und Pränatalmedizin, Halle (Saale), Deutschland
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Zühlke A, Bergner M, Entezami M, Schneider U, Mayer J, Tchirikov M. Anwendung der ultradünnen fetoskopischen Technik reduziert die Verletzung der amnialen Membran und verbessert das neonatale Outcome beim TTTS (ClinicalTrials.gov: NCT03151915). Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1645892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Affiliation(s)
- A Zühlke
- Universitätsklinikum Halle (Saale), Universitätsklinik und Poliklinik für Geburtshilfe und Pränatalmedizin, Zentrum für Fetalchirurgie
| | - M Bergner
- Universitätsklinikum Halle (Saale), Universitätsklinik und Poliklinik für Geburtshilfe und Pränatalmedizin, Zentrum für Fetalchirurgie
| | - M Entezami
- Zentrum für Pränataldiagnostik und Humangenetik, Kurfürstendamm199, Berlin
| | - U Schneider
- Universitätsklinikum Jena, Klinik für Geburtshilfe
| | - J Mayer
- Klinikum Sindelfingen-Böblingen, Zentrum für Frauenheilkunde und Geburtshilfe
| | - M Tchirikov
- Universitätsklinikum Halle (Saale), Universitätsklinik und Poliklinik für Geburtshilfe und Pränatalmedizin, Zentrum für Fetalchirurgie
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Brüning J, Becker R, Entezami M, Loy Y, Vonk R, Weitzel H, Tolxdorff T. Knowledge-Based System ADNEXPERT to Assist the Sonographic Diagnosis of Adnexal Tumors. Methods Inf Med 2018. [DOI: 10.1055/s-0038-1636830] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
ADNEXPERT is a knowledge-based system for the computer- assisted ultrasound diagnosis of adnexal tumors. In a case-based approach, ADNEXPERT used histopathologic and sonographic data from 2,290 adnexal tumors. After an ultrasound examination, the gynecologist interacts with the system. A maximum of 15 questions are posed; all but one question (age) relate to the sonographic findings. The help system gives online access to an ultrasound image library. Once the dialogue is complete, ADNEXPERT assesses the adnexal tumor pathology and makes a histological classification. A certainty factor (CF) model is used for knowledge representation. The CFs of the knowledge base are computed from the case database. During system evaluation, the accuracy of ADNEXPERT was tested by 69 new adnexal tumor cases, for which verified histopathological diagnoses were available. ADNEXPERT accurately assessed pathology in 49 cases (71%); in 10 cases (14%) correct indications to pathology were given; no diagnostic hints were attained in 2 cases (3%); and 8 cases (12%) were falsely diagnosed. Based on the positive results of the evaluation, ADNEXPERT will be tested under clinical conditions.
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Hagen A, Albig M, Keller T, Stumm M, Entezami M. Suspicious Prenasal Skin Thickness-to-Nasal Bone Length Ratio: Prevalence and Correlation with Other Markers in Second and Third Trimester Fetuses with Down Syndrome. Ultraschall Med 2015; 36:501-506. [PMID: 26091004 DOI: 10.1055/s-0034-1399285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
PURPOSE To assess the prevalence and value of a suspicious prenasal skin thickness-to-nasal bone length ratio (PT/NB ratio) in comparison to other established markers in a large population of Down syndrome (DS) fetuses. MATERIALS AND METHODS This was a retrospective study of 139 DS fetuses and 530 normal fetuses scanned after 14 + 0 weeks of gestation. To characterize diagnostic performance, we used the ROC curve approach. The presence or absence of a PT/NB ratio > 0.8 and 11 other markers were assessed in the group of DS fetuses. A correlation analysis was performed in order to investigate associations between PT/NB ratio and other markers. RESULTS Among DS fetuses the median PT/NB ratio was 1.06 (IQR 0.729) and was significantly higher compared to normal fetuses with 0.62 (IQR 0.148), (p < 0.001). Gestational age had no influence on the PT/NB ratio. A PT/NB ratio > 0.8 had the highest prevalence of all markers with 89.2 % in the group of DS fetuses, 3 cases were negative for all markers and 3 cases were positive only for PT/NB ratio > 0.8. Marker-specific comparison between prevalences of a suspicious PT/NB ratio with respect to the presence or absence of other markers was statistically significant for hypoplastic NB and major anomalies (p < 0.05). Utilization of at least one of the following five markers was sufficient for detecting 136 out of 139 fetuses with trisomy 21: suspicious PT/NB ratio, hypoplastic NB, nuchal fold thickness, white spot, shortened femur. CONCLUSION The PT/NB ratio is one of the most powerful indicators of DS in the second trimester. It is objective to interpret, easy to measure, and is reproducible.
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Affiliation(s)
- A Hagen
- Obstetrics and Gynecology, Center for Prenatal Diagnosis and Human Genetics Kudamm-199, Berlin, Germany
| | - M Albig
- Obstetrics and Gynecology, Center for Prenatal Diagnosis and Human Genetics Kudamm-199, Berlin, Germany
| | - T Keller
- Statistik, ACOMED, Leipzig, Germany
| | - M Stumm
- Human Genetics, Center for Prenatal Diagnosis and Human Genetics Kudamm-199, Berlin, Germany
| | - M Entezami
- Obstetrics and Gynecology, Center for Prenatal Diagnosis and Human Genetics Kudamm-199, Berlin, Germany
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Scheler C, Entezami M, Thäle V, Tchirikov M. Die atraumatische 29-Gauge Nadel zur Amniozentese bei choriamnialer Separation. Geburtshilfe Frauenheilkd 2015. [DOI: 10.1055/s-0035-1551581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Abstract
During the last few years, there has been a rapid development in prenatal diagnosis. Due to the improvements in sonographic examinations and the introduction of first-trimester screening, the number of invasive prenatal diagnostic procedures has dropped by more than 50 %. Recently, noninvasive prenatal diagnostic tests with cell-free fetal DNA from maternal blood have also become available and will further enhance this development. As invasive prenatal procedures will become less frequent in the near future, the proportion of procedure-related abortions will further decrease.
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Affiliation(s)
- M Stumm
- Zentrum für Pränataldiagnostik und Humangenetik Kudamm-199, Kurfürstendamm 199, 10719, Berlin, Deutschland,
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Tchirikov M, Entezami M. Verbesserung des neonatalen Outcomes nach Laser-Koagulation bei feto-fetalem Transfusionssyndrom durch Verwendung ultradünner fetoskopischer Technik. Z Geburtshilfe Neonatol 2013. [DOI: 10.1055/s-0033-1361306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Scheler C, Entezami M, Tchirikov M. Anwendung der atraumatischen 29G-Nadel bei 2. Trimester-Amniozentesen mit Chorion-Amnion-Dissoziation. Z Geburtshilfe Neonatol 2013. [DOI: 10.1055/s-0033-1361308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Entezami M, Tchirikov M, Sancken U, Sucker C, Hagen A, Fuchs I. Der Angiogenesequotient sFlt-1/PLGF zur ambulanten Schwangerschaftsüberwachung bei erhöhtem Risiko gestörter Trophoblastinvasion. Geburtshilfe Frauenheilkd 2013. [DOI: 10.1055/s-0033-1347751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Sancken U, Kitschmann-Prawitt M, Becker R, Entezami M. Die Angiogenese-Parameter sFlt-1 (S) und PLGF (P) im individuellen Schwangerschaftsverlauf: Neue Erkenntnisse über die Verwendung des Angiogenesequotienten S/P zur präsymptomatischen Detektion der Präeklampsie und anderer sich spät manifestierender Schwangerschaftskomplikationen. Geburtshilfe Frauenheilkd 2013. [DOI: 10.1055/s-0033-1347719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Karl K, Benoit B, Entezami M, Heling KS, Chaoui R. Small biparietal diameter in fetuses with spina bifida on 11-13-week and mid-gestation ultrasound. Ultrasound Obstet Gynecol 2012; 40:140-144. [PMID: 22511513 DOI: 10.1002/uog.11175] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
OBJECTIVES To assess whether, at 11-13-week and mid-trimester ultrasound examinations, the biparietal diameter (BPD) in fetuses with open spina bifida is smaller than the reference range. METHODS In a multicenter retrospective analysis of data from 23 fetuses with open spina bifida diagnosed at 16-24 weeks, BPD at diagnosis was compared with that measured at 11-13 weeks, before diagnosis. Z-scores were calculated for comparison of BPD deviations from the reference range within the groups at 11-13 weeks and 16-24 weeks, and between these two time intervals. RESULTS BPD Z-scores at 11-13 weeks and 16-24 weeks were significantly lower (P < 0.0001) in fetuses with open spina bifida when compared to the reference range, with mean values of - 1.29 and - 2.14, respectively, corresponding to the 10(th) and 1.5(th) centiles, respectively. At 11-13 weeks only six of the 23 (26%) fetuses with open spina bifida had BPD below the 5(th) centile, in comparison to 16 (69%) at mid-gestation. This was confirmed by paired t-test comparing the first-trimester with the second-trimester BPD measurements, which showed significantly slower growth of the BPD in fetuses with spina bifida. CONCLUSION In fetuses with open spina bifida, BPD is smaller not only in the second trimester, as previously reported, but also in the first trimester. This is most likely due to loss of cerebrospinal fluid. We suggest that a BPD value < 10(th) centile in an otherwise normally grown fetus at 11-13 weeks' gestation should be considered as a potential subtle early marker for open spina bifida.
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Affiliation(s)
- K Karl
- Department of Obstetrics and Gynecology, Maistrasse, Ludwig-Maximilians-University, Munich, Germany
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Hofmann W, Entezami M, Haug K, Blank C, Wüstemann M, Schulze B, Raabe-Meyer G, Hempel M, Freitag-Langer S, Schelling M, Ostermayer E, Burkhardt T, Zimmermann R, Beck M, Schleicher T, Kumar Y, Grömminger S, Stumm M. Klinische Studien zum nicht invasiven Nachweis der fetalen Trisomie 21 aus mütterlichem Blut. Z Geburtshilfe Neonatol 2012. [DOI: 10.1055/s-0032-1309105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Tchirikov M, Falkert A, Huber G, Entezami M. Neonatales Outcome nach Laser-Koagulation mit ultradünnem Fetoskop bei feto-fetalem Transfusionssyndrom. Z Geburtshilfe Neonatol 2011. [DOI: 10.1055/s-0031-1293233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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Tchirikov M, Falkert A, Huber G, Entezami M. Verwendung eines ultradünnen Fetoskopes für die Laser-Koagulation plazentarer Anastomosen bei feto-fetalem Transfusionssyndrom verbessert signifikant das neonatale Outcome. Geburtshilfe Frauenheilkd 2011. [DOI: 10.1055/s-0031-1292697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022] Open
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Hagen A, Entezami M, Gasiorek-Wiens A, Albig M, Becker R, Knoll U, Stumm M, Wegner RD. The impact of first trimester screening and early fetal anomaly scan on invasive testing rates in women with advanced maternal age. Ultraschall Med 2011; 32:302-306. [PMID: 20972947 DOI: 10.1055/s-0029-1245560] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
PURPOSE To evaluate the acceptance of noninvasive screening for trisomy 13, 18, 21 and the impact on invasive testing rates in women at an age≥35 years. MATERIALS AND METHODS In a retrospective analysis from 2003-2006 including 13 268 women≥35 years old with singleton pregnancies and 3133 invasive procedures, we evaluated the prenatal detection rate of aneuploidies in two cohorts. Group 1: advanced maternal age as sole indication, group 2: additional abnormalities and/or suspicious maternal serum parameters. In an additional analysis from 1998-2006 including 31,076 patients≥35 years, we investigated the shift in time of sonography at 11+0-13+6, 14+0-17+6 and 18+0-22+6 gestational weeks (gw). RESULTS Among 13,268 women, 3133 invasive tests were performed with a significant decrease over time (-17%). 9% of women chose invasive testing after a normal ultrasound (group 1, n=1,267) and 14% in the case of additional markers (group 2, n=1,866). 102 cases of aneuploidy were disclosed. The proportion of detected aneuploidies was 0.86% in group 1 and 4.9% in group 2. No change in the overall detection rate (90-93%) was observed. The number of patients≥40 years increased significantly (+2.8%). There was an increase in examinations at 11+0-13+6 gw (+8%), a decrease at 14+0-17+6 gw (-10.3%) and no significant change at 18+0-22+6 gw over time. CONCLUSION Increasing numbers of women≥35 years of age rely on the individually adjusted risk figure to make a decision about invasive testing. The application of these selective procedures can reduce the rates of invasive testing with fewer losses of normal fetuses and led to an earlier diagnosis of aneuploidies.
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Affiliation(s)
- A Hagen
- Obstetrics and Gynecology, Center for Prenatal Diagnosis Kudamm-199, Berlin.
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Entezami M, Hartmann K, Albig M, Gasiorek-Wiens A, Becker R, Hagen A. Der leere oder fast leere Magen beim Fehlbildungsscreening – kein guter Marker für die Ösophagusatresie. Z Geburtshilfe Neonatol 2009. [DOI: 10.1055/s-0029-1222867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Entezami M, Tillig B, Hagen A, Albig M, Schaible T. Intrauterine Spontantherapie bei Zwerchfellhernie durch passagere Bronchusobstruktion mit Vortäuschung einer CCAM? Z Geburtshilfe Neonatol 2009. [DOI: 10.1055/s-0029-1222868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Entezami M, Hagen A, Albig M. Uteriner Doppler – der Messpunkt entscheidet! Z Geburtshilfe Neonatol 2009. [DOI: 10.1055/s-0029-1222865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Entezami M, Lebek H, Liepe L, Albig M, Gasiorek-Wiens A, Hagen A. Pränatale diagnostizierte Zwerchfellhernie – was entscheidet über das weitere Procedere? Z Geburtshilfe Neonatol 2009. [DOI: 10.1055/s-0029-1222866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Hagen A, Albig M, Schmitz L, Hopp H, Entezami M. [Intrauterine treatment of incomplete fetal heart block in a mother with Sjögren syndrome]. Ultraschall Med 2008; 29 Suppl 5:268-270. [PMID: 18008217 DOI: 10.1055/s-2007-963551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
BACKGROUND Isolated fetal heart block is considered as an immunological disorder in the majority of cases. Mothers of affected fetuses often suffer from connective tissue disease (Sjögren syndrome or Lupus erythematodes). All of them test positive for anti-SS-A (anti Ro) and/or anti-SS-B (anti La) antibodies. Once established, third-degree congenital heart block is permanent and often requires a pacemaker. CASE We report on a pregnancy in a mother with Sjögren syndrome which was complicated by the development of incomplete fetal heart block, diagnosed by pulsed wave Doppler echocardiography. We started oral dexamethasone treatment to reduce immune-mediated fetal cardiac damage and to prevent complications like hydrops fetalis. CONCLUSION Detection of isolated fetal heart block is possible with pulsed Doppler sonography, but there are no clear recommendations for treatment.
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Affiliation(s)
- A Hagen
- Center for Prenatal Diagnosis Kudamm-199, Berlin, Germany.
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Schmid O, Hagen A, Sarioglu N, Hopp H, Entezami M, Albig M, Becker R. Early diagnosis of conjoined twins by real-time three-dimensional ultrasound--case report and review of the literature. Ultraschall Med 2006; 27:384-8. [PMID: 16612786 DOI: 10.1055/s-2005-858357] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
In 1:50 000 to 1:100 000 births, conjoined twins occur, caused by incomplete division of the embryonic disc more than 13 days after fertilisation. We present a case of cephalothoracopagus janiceps, a very rare form of conjoined twins, which was diagnosed at 13 weeks of gestation. Three-dimensional and colour Doppler ultrasound enabled precise prenatal visualisation of the fusion of the foetal head and chest up to the umbilicus. We could demonstrate the presence of two foetal hearts connected by an arterio-arterial shunt as well as two pairs of upper and lower extremities. After the clear 3-D presentation of the anomaly, making the poor prognosis visible, the mother decided to have the pregnancy terminated. Autopsy confirmed the prenatal diagnosis.
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Affiliation(s)
- O Schmid
- Charité--Campus Benjamin Franklin, Department of Obstetrics and Gynecology, Berlin, Germany.
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Entezami M, Lange J, Chaoui R, Albig M, Wegner RD, Stumm M. Congenital high airway obstruction sequence (CHAOS): Diagnose in der 22. SSW nach unauffälligem Befund in der 13. SSW. Z Geburtshilfe Neonatol 2005. [DOI: 10.1055/s-2005-923141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Entezami M, Weinert I, Albig M, Gasiorek-Wiens A, Becker R, Hagen A, Wegner RD, Stumm M. Die singuläre Nabelarterie - ein Hinweiszeichen auf die Ösophagusatresie? Z Geburtshilfe Neonatol 2005. [DOI: 10.1055/s-2005-923142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Entezami M, Krommydakis T, Hagen A, Albig M, Gasiorek-Wiens A, Becker R, Wegner RD, Stumm M. Softmarker für Chromosomenanomalien bei der Fehlbildungsdiagnostik - eine erhebliche Belastung für Schwangere und Arzt! Z Geburtshilfe Neonatol 2005. [DOI: 10.1055/s-2005-923049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Hagen A, Albig M, Schmitz L, Hopp H, van Baalen A, Becker R, Entezami M. Prenatal Diagnosis of Isolated Foramen ovale Obstruction. Fetal Diagn Ther 2004; 20:70-3. [PMID: 15608464 DOI: 10.1159/000081373] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2003] [Accepted: 03/12/2004] [Indexed: 11/19/2022]
Abstract
Premature obstruction of the foramen ovale is a rare but serious clinical entity. Obstruction can be associated with right ventricular failure, fetal hydrops, tricuspid regurgitation, left heart obstructive defects and supraventricular tachycardia. In most cases, the diagnosis is made at the postmortem examination. The etiology is unknown. We discuss 2 prenatal cases with the sole diagnosis of ventricular asymmetry. The right ventricle was dilated and hypertrophic, and the foramen ovale ballooned into the left atrium without color Doppler detection of right-to-left flow. After delivery, the infants had no hydrops or symptoms of cardiac or respiratory distress. Echocardiography demonstrated a structurally normal heart with increased right ventricle dimensions until the 7th day of life. Delivery should be induced if possible in cases of foramen ovale obstruction with signs of cardiac decompensation.
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Affiliation(s)
- A Hagen
- Charité University Medicine Berlin, Campus Benjamin Franklin, Department of Obstetrics and Gynecology, Center of Prenatal Diagnosis Berlin, Germany.
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Schmid O, Hopp H, Entezami M, Hagen A. Menagement fetaler Tachykardien. Z Geburtshilfe Neonatol 2004. [DOI: 10.1055/s-2003-818300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Hagen A, Albig M, Altinöz H, Hopp H, Entezami M. Pränatale Diagnose einer Obstruktion des Foramen ovale – 2 Fallbeispiele. Z Geburtshilfe Neonatol 2004. [DOI: 10.1055/s-2003-818172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Sarioglu N, Wegner RD, Gasiorek-Wiens A, Entezami M, Schmock J, Hagen A, Becker R. Epignathus: always a simple teratoma? Report of an exceptional case with two additional fetiforme bodies. Ultrasound Obstet Gynecol 2003; 21:397-403. [PMID: 12704752 DOI: 10.1002/uog.92] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
We report on a case of a fetal epignathus combined with two fetus-like structures resembling acardius acranius. The anomaly was detected at 23 weeks of gestation and led to termination of pregnancy at 24 weeks. This is the first description of epignathus with parasitic fetuses detected prenatally. It shows that the boundary between fetal teratoma and multiple pregnancy in special cases may be difficult to define.
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Affiliation(s)
- N Sarioglu
- Department of Paidopathology, Klinikum Rudolf Virchow, Humboldt University, Germany
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Becker R, Kunze J, Horn D, Gasiorek-Wiens A, Entezami M, Rossi R, Guschmann M, Sarioglu N. Autosomal recessive type of Adams-Oliver syndrome: prenatal diagnosis. Ultrasound Obstet Gynecol 2002; 20:506-510. [PMID: 12423491 DOI: 10.1046/j.1469-0705.2002.00839.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
We report on three pregnancies complicated by Adams-Oliver syndrome in a consanguineous Turkish couple. Two cases were correctly diagnosed prenatally at 22+3 and 13+0 weeks gestation following the first case of Adams-Oliver syndrome in which severe anomalies of the extremities were observed at 26+5 weeks' gestation. In this first case, the diagnosis of Adams-Oliver syndrome was made following termination of pregnancy at 27+2 weeks' gestation. In all three cases, autopsy was performed. All fetuses showed anomalies of the extremities, aplasia cutis and symmetric defects of the skull, with bone being replaced by collagenous tissue. Although there have been numerous cases of the postnatal diagnosis of Adams-Oliver syndrome following termination of pregnancy, this is the first description of the prenatal diagnosis of this disorder.
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Affiliation(s)
- R Becker
- Department of Obstetrics and Gynaecology, Klinikum Benjamin Franklin, Free University of Berlin, Berlin, Germany.
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Guschmann M, Becker R, Urban M, Entezami M, Hese S, Vogel M. [Femur-fibula-ulna (FFU) complex in the 33rd week of gestation: ultrasonography, radiology, pathology and differential diagnosis. Case report]. Klin Padiatr 2001; 213:301-5. [PMID: 11582532 DOI: 10.1055/s-2001-17225] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
We present a case of a 27 year old I. gravida, I. para. Despite of regular ultrasonographic examination the diagnosis of skeletal malformation at the fetus was not before 33. weeks of gestation. It was the rare type of a bothside femur-fibula-ulna (FFU) complex. The FFU-complex is a no lethal malformation with typical unilateral combination from defects of femur and fibula, with contralateral defect of ulna. Dependent to involvement of malformated limbs the FFU-complex is classifiable in four groups. Only in 10 % all limbs are affected. Our case (type IV) showed a peromelia of both upper limbs with stumps of humeri, bothside aplasia of fibula and missing from 4. and 5. toes. There fetus were without nonlimb congenital abnormalities. The etiology of FFU-complex is unknown, the occurrence sporadic. There are never found genetic abnormalities. Familial recurrence is not described. There is no maternal or paternal age effect on FFU-complex. The differential diagnosis must include malformations with reduction anomalies of extremities, like thalidomide syndrome, splenogonadal fusion with limb malformations, Roberts syndrome, oroacral complex or acheiropodia. Mark off are amniotic band too.
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Affiliation(s)
- M Guschmann
- Abteilung für Paidopathologie und Plazentologie, Universitätsklinikum Charité, Virchow-Klinikum, Medizinische Fakultät der Humboldt-Universität zu Berlin, Germany.
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Becker R, Stiemer B, Neumann L, Entezami M. Mild ventriculomegaly, mild cerebellar hypoplasia and dysplastic choroid plexus as early prenatal signs of CHARGE association. Fetal Diagn Ther 2001; 16:280-3. [PMID: 11509849 DOI: 10.1159/000053928] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CHARGE association has been diagnosed postnatally in increasing numbers since the first description in 1979. The acronym CHARGE includes the abnormalities ocular Colobomas (iris, retina or nervus opticus), Heart disease, Atresia of choanae, Retarded growth and development and/or central nervous system anomalies, Genital hypoplasia, Ear anomalies and deafness. So far, no prenatal diagnosis of the CHARGE association has been described; only one case report presents prenatal symptoms detected at 31 gestational weeks. In our case, prenatally detected mild cerebral ventriculomegaly and dysplasia of choroid plexus were abnormalities visible as early as 15+6 weeks as well as mild cerebellar hypoplasia at 21+1 weeks. At 28+6 weeks, in addition polyhydramnios could be found. The combination of the 'benign' central-nervous findings raised suspicion of a severe congenital malformation at 21+1 weeks which was confirmed postnatally in the form of diagnosis of CHARGE association.
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Affiliation(s)
- R Becker
- Department of Obstetrics and Gynaecology, University Clinic Benjamin Franklin, Free University of Berlin, Berlin, Germany.
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Becker RH, Vonk R, Mende BC, Ragosch V, Entezami M. The relevance of placental location at 20-23 gestational weeks for prediction of placenta previa at delivery: evaluation of 8650 cases. Ultrasound Obstet Gynecol 2001; 17:496-501. [PMID: 11422970 DOI: 10.1046/j.1469-0705.2001.00423.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
OBJECTIVE To determine the correlation between placental position at 20-23 weeks and incidence of birth complications caused by placental position. SUBJECTS AND METHODS In an ongoing prospective study, placental position was determined by transabdominal sonography as part of anomaly scanning at 20-23 gestational weeks, followed by transvaginal sonography in uncertain or suspicious situations. Examination was performed in 9532 cases; feedback was obtained from 8650 patients (90.7%). RESULTS Transabdominal sonography was followed by transvaginal scan in 363 of 8650 cases (4.2%). In 8551 cases (98.9%), we found normal placental position, with the placenta not reaching the internal os and a Cesarean section rate of 17.1% (1458/8551). The incidence of 'low placental position', with the placenta reaching the internal os was 0.66% (57/8650), with a Cesarean section rate of 21% (12/57). In 0.49% (42/8650) of cases, the placenta overlapped the internal os at 20-23 weeks; Cesarean section because of placenta previa or bleeding was performed in 28 of 8650 cases (0.32%). Vaginal delivery was possible in 43% of cases (13/30), when the overlap did not exceed 25 mm. If the overlap exceeded 25 mm (12 cases), no vaginal delivery was reported. There was no reported case of placenta previa missed at the 20-23-week scan. CONCLUSION At 20-23 weeks, a combination of routine transabdominal and indication-based transvaginal location of placental position is a powerful tool in predicting placenta previa at delivery. The advantage of determining placental position at this stage of pregnancy is a low false-positive rate compared to at earlier stages of pregnancy. We conclude that an overlapping placenta at 20-23 weeks has the consequence of a high probability of placenta previa at delivery. An overlap of 25 mm or more at 20-23 weeks seems to be incompatible with later vaginal delivery.
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Affiliation(s)
- R H Becker
- Free University of Berlin, University Hospital Benjamin Franklin, Department of Obstetrics and Gynecology, Berlin, Germany.
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Guschmann M, Horn D, Entezami M, Urban M, Hänel S, Kunze J, Vogel M. Mesomelic campomelia, polydactyly and Dandy-Walker cyst in siblings. Prenat Diagn 2001; 21:378-82. [PMID: 11360278 DOI: 10.1002/pd.70] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
The present report describes two fetuses, one female and one male, with thus far undescribed skeletal malformations. The mother was a gravida 2, para 0. Both pregnancies were terminated in the second trimester because of multiple congenital anomalies diagnosed ultrasonographically resembling a short rib-polydactyly syndrome. Both fetuses were found to have postaxial hexadactyly of the hands and feet, marked bilateral campomelia of the forearm and shank bones, and a Dandy-Walker cyst. In addition, the fourth ventricle was dilated in the first sibling and the second sibling had an inverse intestinal malrotation. A literature search failed to reveal similar observations.
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Affiliation(s)
- M Guschmann
- Abteilung für Paidopathologie und Placentologie, Institute für Pathologie, Charité, Campus Virchow-Klinikum, Medizinische Fakultät der Humboldt-Universität zu Berlin, Berlin, Germany.
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Becker R, Schmitz L, Guschmann M, Wegner RD, Stiemer B, Entezami M. Prenatal diagnosis of familial absent pulmonary valve syndrome: case report and review of the literature. Ultrasound Obstet Gynecol 2001; 17:263-267. [PMID: 11309181 DOI: 10.1046/j.1469-0705.2001.00242.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
We report on a case of absent pulmonary valve syndrome in a woman with a history of one healthy child and one child with tetralogy of Fallot with absent pulmonary valve. The diagnosis was missed at the first ultrasound examination performed at 13 + 5 weeks of gestation and correctly diagnosed at 21 + 5 weeks. Re-evaluation of the ultrasound examination recorded at 13 + 5 weeks exhibited severe insufficiency of the pulmonary valve at this time. However, neither dilatation of the right and left pulmonary arteries nor asymmetry of the ventricles were present at that time. The pregnancy was terminated at 22 + 1 weeks of gestation when autopsy confirmed the diagnosis of absent pulmonary valve syndrome. Karyotyping of the fetus after termination of pregnancy revealed normal chromosomes. Echocardiography of the parents and the healthy sibling revealed normal results.
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Affiliation(s)
- R Becker
- Free University of Berlin, Klinikum Benjamin Franklin, Department of Obstetrics and Gynaecology, Berlin, Germany.
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Abstract
Following the introduction of transvaginal sonography, several first trimester diagnoses of the exencephaly anencephaly sequence have been reported, with the earliest being described at 10 weeks of gestation. We report a case with a high index of suspicion for exencephaly at 9 weeks and 3 days because of three sonographic features: the cranial pole of the embryo was smaller than the chest, the cranial pole bulged dorsally and the surface of the cranium was irregular. The diagnosis was confirmed by a repeat ultrasound examination at 11 + 4 weeks and by autopsy after termination of pregnancy.
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Affiliation(s)
- R Becker
- Free University of Berlin, Klinikum Benjamin Franklin, Department of Obstetrics and Gynaecology, 199, 10719 Berlin, Germany
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Abstract
We report on a case of embryonic anomaly detected at 9 + 5 gestational weeks. The lower part of the embryo was located in the coelomic cavity. Lower extremities could not be depicted. The abdominal wall showed the appearance of omphalocoele. After termination of pregnancy at 10 weeks, autopsy confirmed the anomaly of the lower embryonic parts consistent with the diagnosis of body stalk anomaly. To our knowledge, this is the first observation of this condition before 10 gestational weeks.
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Affiliation(s)
- R Becker
- Department of Obstetrics and Gynaecology, University Clinic Benjamin Franklin, Free University of Berlin, Berlin, Germany.
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Becker R, Wegner RD, Kunze J, Runkel S, Vogel M, Entezami M. Clinical variability of Larsen syndrome: diagnosis in a father after sonographic detection of a severely affected fetus. Clin Genet 2000; 57:148-50. [PMID: 10735637 DOI: 10.1034/j.1399-0004.2000.570210.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Larsen syndrome shows a broad spectrum of clinical manifestation ranging from a lethal form of the disorder to a mild clinical expression with absence of major diagnostic features. Here we show that even intrafamilial manifestation may vary extremely to the point that Larsen syndrome in a father has been diagnosed only by typical sonographic features in an affected fetus.
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Affiliation(s)
- R Becker
- Free University of Berlin, Klinikum Benjamin Franklin, Germany
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Entezami M, Hardt W, Ebert A, Runkel S, Becker R. [Hepatocellular carcinoma as a rare cause of excessive rise in alpha-fetoprotein in pregnancy]. Zentralbl Gynakol 1999; 121:503-5. [PMID: 10573826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
OBJECTIVE Elevation of alphafetoprotein in pregnancy warrants a thorough diagnostic workup. In most cases, no pathologic result in the fetus will be obtained. CASE REPORT A case report is presented on a hepatocellular carcinoma (HCC) during pregnancy, in which a massive increase of alpha-fetoprotein (AFP) was found during a routine screening for neural tube defects in the 17th week of gestation. The amniocentesis revealed a normal AFP value in the amniotic fluid. Liver sonography in the 21st week of gestation showed a 5 cm tumor, which was interpreted as nodular focal hyperplasia. In the control sonography in the 32nd week of gestation, there was a growth to 12 cm. The subsequently performed magnetic resonance imaging (MRI) and fine needle aspiration led to the diagnosis of a HCC. Delivery was performed in the 34th week of gestation by cesarean section followed by surgical therapy of the HCC. CONCLUSIONS Unexplained cases of alphafetoproteinelevation in pregnancy can be caused by maternal disease and should prompt a directed amnamnestic and diagnostic search for maternal causes. Nuclear magnetic resonance beyond the first trimester of gestation can help to clarify the diagnosis in liver tumors.
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Affiliation(s)
- M Entezami
- Frauenklinik, Universitätsklinikum Benjamin Franklin, Freie Universität Berlin.
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Entezami M, Vonk R, Becker R. Nuchal cord. Ultrasound Obstet Gynecol 1999; 14:362-363. [PMID: 10624000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
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Ebert AD, Hopp HS, Entezami M, Runkel S, Weitzel HK. Acute onset of blindness during labor: report of a case of transient cortical blindness in association with HELLP syndrome. Eur J Obstet Gynecol Reprod Biol 1999; 84:111-3. [PMID: 10413240 DOI: 10.1016/s0301-2115(98)00300-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The coincidence of HELLP syndrome and cortical blindness is an uncommon but very dramatic event, for the patient as well as the obstetrician. This report describes the first case of HELLP-syndrome-associated cortical blindness occuring suddenly in the third stage of labour. There were only modest correlates of cortical blindness in cerebral CT, MRI and angiography findings, but no signs of a posterior leucoencephalopathy syndrome. Mother and baby were discharged from hospital to outpatient care in good health on the 12th day.
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Affiliation(s)
- A D Ebert
- Department of Obstetrics and Gynecology, Medical Center Benjamin Franklin, Free University Berlin, Germany.
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Hardt W, Entezami M, Vogel M, Becker R. Die fetale Exenzephalie - Vorstadium der Anenzephalie? Ein kasuistischer Beitrag. Geburtshilfe Frauenheilkd 1999. [DOI: 10.1055/s-1999-14176] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
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Ebert AD, Perez-Canto A, Schaller G, Entezami M, Hopp HS, Weitzel HK. Stage I primary malignant mixed müllerian tumor of the fallopian tube. Report of a case with five-year survival after minimal surgery without adjuvant treatment. J Reprod Med 1998; 43:598-600. [PMID: 9693413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND Sarcomas of the fallopian tube are rarities in gynecologic oncology, consisting of < 1% of all genital sarcomas. CASE A 70-year-old woman with a stage I malignant mixed müllerian tumor (MMMT) (International Federation of Gynecology and Obstetrics classification of fallopian tube carcinomas) did not undergo radical surgery or adjuvant treatment because of the patient's refusal of them. The patient underwent only abdominal hysterectomy with bilateral salpingo-oophorectomy. She was discharged feeling well and without abnormal clinical findings. Sixty months after primary surgery there were no signs of recurrence. CONCLUSION This case suggests the possibility of a good prognosis in early-stage MMMT, especially if there is no deep infiltration of the fallopian tube muscle layer or lymphatic permeation and if the peritoneal cytology is negative. The important feature of this report is the five year disease-free survival after nonradical surgery for prognostically favorable MMMT.
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Affiliation(s)
- A D Ebert
- Department of Gynecology and Obstetrics, Benjamin Franklin Medical Center, Free University of Berlin, Germany.
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Entezami M, Halis G, Waldschmidt J, Opri F, Runkel S. Congenital cystic adenomatoid malformation of the lung and fetal hydrops--a case with favourable outcome. Eur J Obstet Gynecol Reprod Biol 1998; 79:99-101. [PMID: 9643413 DOI: 10.1016/s0301-2115(98)00035-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
We present a case of congenital cystic adenomatoid malformation of the lung (CCAM) diagnosed at 23 weeks of gestation with concomitant fetal hydrops. The sonographical picture of CCAM disappeared in the third trimester of pregnancy and fetal hydrops resolved under medication with digitalis to the mother. The neonate showed mild dyspnea; the prenatal diagnosis of CCAM was confirmed by chest X-ray and computed tomography. The affected lung segments were dissected at 5 days of age. The diagnosis of CCAM type III was confirmed histologically.
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Affiliation(s)
- M Entezami
- Department of Obstetrics and Gynecology, University Hospital Benjamin Franklin, Free University of Berlin, Germany.
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Abstract
Advances in ultrasound technology and sonographer's experience lead to the description of many rare syndromes and malformations through prenatal diagnosis. Diaphragmatic hernia is a rather common malformation but can be an indicator of different syndromes. We report the prenatal diagnosis of lethal multiple pterygium syndrome type II which has been established in the 34th week of pregnancy. The sonographically detectable symptoms consisted of polyhydramnios, hygroma colli, diaphragmatic hernia, scoliosis, short forearms, hypokinesia of the fetus and pterygia over the large joints. Labour was induced in the 34th week of pregnancy; the neonate died shortly after vaginal delivery as a result of the pulmonary hypoplasia. A multidisciplinary approach in prenatal assessment may help to clarify difficult diagnostic problems and may be of direct benefit for the pregnant patient.
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Affiliation(s)
- M Entezami
- Department of Gynecology, University Medical Center Benjamin Franklin, Free University of Berlin, Germany.
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Guschmann M, Entezami M, Becker R, Vogel M. Intrauterine rhabdomyoma of the heart. A case report. Gen Diagn Pathol 1997; 143:255-9. [PMID: 9489961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Primary cardiac tumors are rare findings in adults and children. A case is presented in which ultrasound examination revealed an incredibly large tumor in the heart of a fetus at 24 weeks. Tumor filled the whole left ventricle. Histology and immunohistochemistry were indicative of rhabdomyoma, i.e., a hamartoma that is often associated with tuberous sclerosis.
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Affiliation(s)
- M Guschmann
- Department of Pediatric Pathology and Placentology, Medical Faculty of the Virchow Hospital, Humboldt University, Berlin, Germany
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