Mercury biomagnification in the food web of Agami Pond, Kaw-Roura Nature Reserve, French Guiana

Freshwater ecosystems are among the most important ecosystems worldwide, however, over the last centuries, anthropogenic pressures have had catastrophic effects on them. Mercury (Hg) is one of the main environmental contaminants which globally affect ecosystems and particularly freshwater wildlife. While Hg originates from natural sources, anthropogenic activities such as agriculture, biomass combustion, and gold mining increase its concentrations. Gold mining activities are the main drivers of Hg emission in tropical ecosystems and are responsible for up to 38% of global emissions. Once in its methylated form (MeHg), mercury biomagnifies through the trophic chain and accumulates in top predators. Due to the toxicity of MeHg, long-lived predators are even more subjected to chronic effects as they accumulate Hg over time. In the present study we quantified Hg contamination in two top predators, the Black caiman Melanosuchus niger and the Agami heron Agamia agami, and in their prey in the Kaw-Roura Nature Reserve in French Guiana and evaluated the biomagnification rate in the trophic chain. Our results show that despite a TMF in the range of others in the region (4.38 in our study), top predators of the ecosystem present elevated concentrations of Hg. We have found elevated Hg concentrations in the blood of adult Black caiman (2.10 ± 0.652 μg g-1 dw) and chicks of Agami heron (1.089 ± 0.406 μg g-1 dw). These findings highlight the need to better evaluate the potential impact of Hg in freshwater top predators, especially regarding reprotoxic effects.

Relationships between stable isotopes and trace element concentrations in the crocodilian community of French Guiana

Trace elements in the blood of crocodilians and the factors that influence their concentrations are overall poorly documented. However, determination of influencing factors is crucial to assess the relevance of caimans as bioindicators of environmental contamination, and potential toxicological impact of trace elements on these reptiles. In the present study, we determined the concentrations of 14 trace elements (Ag, As, Cd, Cr, Co, Cu, Fe, Hg, Pb, Mn, Ni, Se, V, and Zn) in the blood of four French Guiana caiman species (the Spectacled Caiman Caiman crocodilus [n = 34], the Black Caiman Melanosuchus niger [n = 25], the Dwarf Caiman Paleosuchus palpebrosus [n = 5] and the Smooth-fronted Caiman Paleosuchus trigonatus [n = 20]) from 8 different sites, and further investigated the influence of individual body size and stable isotopes as proxies of foraging habitat and trophic position on trace element concentrations. Trophic position was identified to be an important factor influencing trace element concentrations in the four caiman species and explained interspecific variations. These findings highlight the need to consider trophic ecology when crocodilians are used as bioindicators of trace element contamination in environmental studies.

Naive poison frog tadpoles use bi-modal cues to avoid insect predators but not heterospecific predatory tadpoles

For animals to survive until reproduction, it is crucial that juveniles successfully detect potential predators and respond with appropriate behavior. The recognition of cues originating from predators can be innate or learned. Cues of various modalities might be used alone or in multi-modal combinations to detect and distinguish predators but studies investigating multi-modal integration in predator avoidance are scarce. Here, we used wild, naive tadpoles of the Neotropical poison frog Allobates femoralis ( Boulenger, 1884) to test their reaction to cues with two modalities from two different sympatrically occurring potential predators: heterospecific predatory Dendrobates tinctorius tadpoles and dragonfly larvae. We presented A. femoralis tadpoles with olfactory or visual cues, or a combination of the two, and compared their reaction to a water control in a between-individual design. In our trials, A. femoralis tadpoles reacted to multi-modal stimuli (a combination of visual and chemical information) originating from dragonfly larvae with avoidance but showed no reaction to uni-modal cues or cues from heterospecific tadpoles. In addition, visual cues from conspecifics increased swimming activity while cues from predators had no effect on tadpole activity. Our results show that A. femoralis tadpoles can innately recognize some predators and probably need both visual and chemical information to effectively avoid them. This is the first study looking at anti-predator behavior in poison frog tadpoles. We discuss how parental care might influence the expression of predator avoidance responses in tadpoles.

Lead, mercury, and selenium alter physiological functions in wild caimans (Caiman crocodilus)

Environmental contaminants affect ecosystems worldwide and have deleterious effects on biota. Non-essential mercury (Hg) and lead (Pb) concentrations are well documented in some taxa and are described to cause multiple detrimental effects on human and wildlife. Additionally, essential selenium (Se) is known to be toxic at high concentrations but, at lower concentrations, Se can protect organisms against Hg toxicity. Crocodilians are known to bioaccumulate contaminants. However, the effects of these contaminants on physiological processes remain poorly studied. In the present study, we quantified Hg, Pb and Se concentrations in spectacled caimans (Caiman crocodilus) and investigated the effects of these contaminants on several physiological processes linked to osmoregulatory, hepatic, endocrine and renal functions measured through blood parameters in 23 individuals. Mercury was related to disruption of osmoregulation (sodium levels), hepatic function (alkaline phosphatase levels) and endocrine processes (corticosterone levels). Lead was related to disruption of hepatic functions (glucose and alanine aminotransferase levels). Selenium was not related to any parameters, but the Se:Hg molar ratio was positively related to the Na⁺ and corticosterone concentrations, suggesting a potential protective effect against Hg toxicity. Overall, our results suggest that Hg and Pb alter physiological mechanisms in wild caimans and highlight the need to thoroughly investigate the consequences of trace element contamination in crocodilians.

Variation of Total Mercury Concentrations in Different Tissues of Three Neotropical Caimans: Implications for Minimally Invasive Biomonitoring

Mercury (Hg) is a global environmental contaminant that affects ecosystems. It is known to biomagnify through food webs and to bioaccumulate especially in the tissues of top predators. Large-scale comparisons between taxa and geographic areas are needed to reveal critical trends related to Hg contamination and its deleterious effects on wildlife. Yet, the large variety of tissues (keratinized tissues, internal organs, blood) as well as the variability in the units used to express Hg concentrations (either in wet- or dry-tissue weight) limits straightforward comparisons between studies. In the present study, we assessed the moisture content that could influence the total Hg (THg) concentrations measured in several tissues (claws, scutes, total blood, and red blood cells) of three caiman species. We evaluated the moisture content from the different tissues to provide information on THg concentrations in various matrices. Our results show a difference of THg concentrations between the tissues and intra- and interspecific variations of moisture content, with the highest THg values found in keratinized tissues (scute keratinized layers and claws). For the three species, we found positive relationships between body size and THg concentration in keratinized tissues. In the blood, the relationship between body size and THg concentration was species-dependent. Our results emphasize the need for a standardized evaluation of THg concentration and trace elements quantification based on dry weight analytical procedures. In addition, the use of both blood and keratinized tissues offers the possibility to quantify different time scales of THg exposure by non-lethal sampling.

I got it from my mother: Inter-nest variation of mercury concentration in neonate Smooth-fronted Caiman (Paleosuchus trigonatus) suggests maternal transfer and possible phenotypical effects

The deleterious effects of mercury (Hg) contamination are well documented in humans and wildlife. Chronic exposure via diet and maternal transfer are two pathways which increase the toxicological risk for wild populations. However, few studies examined the physiological impact of Hg in crocodilians. We investigated the Hg contamination in neonate Smooth-fronted Caimans, Paleosuchus trigonatus, and the use of keratinized tissues and blood to evaluate maternal transfer. Between November 2017 and February 2020, we sampled 38 neonates from 4 distinct nests. Mercury concentration was measured in claws, scutes and total blood. Highest Hg concentrations were found in claws. Strong inter-nest variations (Hg ranging from 0.17 ± 0.02 to 0.66 ± 0.07 μg.g^-1 dw) presumably reflect maternal transfer. Reduced body size in neonates characterized by elevated Hg concentrations suggests an influence of Hg during embryonic development. We emphasize the use of claws as an alternative to egg collection to investigate maternal transfer in crocodilians. Our results demonstrated the need of further investigation of the impact of Hg contamination in the first life stages of crocodilians.

Improving image quality of mid-trimester fetal sonography in obese women: role of ultrasound propagation velocity

OBJECTIVE

The quality of ultrasound images is impaired in obese patients. All ultrasound scanners are calibrated for an ultrasound propagation velocity of 1540 m/s, but the propagation in fatty tissue is slower (in the order of 1450 m/s). The main objective of this study was to evaluate the quality of images obtained with different ultrasound propagation velocity settings during the mid-trimester fetal ultrasound examination in obese patients.

METHODS

This was a cross-sectional study using image sets of four recommended scanning planes collected from 32 obese pregnant women during their mid-trimester fetal scan. Each image set comprised three images obtained successively at three different propagation velocity settings (1540 m/s, 1480 m/s and 1420 m/s). A panel of 114 experts assessed the quality of 100 image sets, grading them from A (most acceptable) to C (least acceptable). Scanning-plane-specific indicators of adiposity (fatty layer thickness, probe-to-organ distance) were analyzed for each scanning plane.

RESULTS

The experts had a mean of 18.1 ± 10.2 years of experience. The grade distribution (A, B, C) differed significantly (P < 0.0001) between the three propagation velocity settings tested; at the lower speed of 1480 m/s, images were most often graded A, while at the conventional speed of 1540 m/s, they were most often graded C. Regardless of the scanning plane, the thicker the fatty layer of the abdominal wall in a given plane, the lower the preferred speed (P < 0.0001).

CONCLUSION

The construction of images taking into account ultrasound propagation velocities lower than 1540 m/s can improve significantly the quality of images obtained during mid-trimester fetal ultrasonography in obese women. Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd.

Hierarchical decision-making balances current and future reproductive success

Parental decisions in animals are often context‐dependent and shaped by fitness trade‐offs between parents and offspring. For example, the selection of breeding habitats can considerably impact the fitness of both offspring and parents, and therefore, parents should carefully weigh the costs and benefits of available options for their current and future reproductive success. Here, we show that resource‐use preferences are shaped by a trade‐off between parental effort and offspring safety in a tadpole‐transporting frog. In a large‐scale in situ experiment, we investigated decision strategies across an entire population of poison frogs that distribute their tadpoles across multiple water bodies. Pool use followed a dynamic and sequential selection process, and transportation became more efficient over time. Our results point to a complex suite of environmental variables that are considered during offspring deposition, which necessitates a highly dynamic and flexible decision‐making process in tadpole‐transporting frogs.

Implementing the INTERGROWTH-21st fetal growth standards in France: a 'flash study' of the College Français d'Echographie Foetale (CFEF)

OBJECTIVES

To assess potential differences in fetal size between the French population and the international population from the INTERGROWTH-21^st (IG-21^st ) Project and to measure the impact of switching to the IG-21^st reference standards for fetal size.

METHODS

This was a nationwide cross-sectional study of fetal ultrasound biometry. Low-risk singleton pregnancies were recruited prospectively within the network of the national French College of Fetal Ultrasound, CFEF, over a 6-week period. Further selection was performed based on the criteria of the IG-21^st Project in order to obtain a comparable population. Head circumference (HC) was used as the main fat-free skeletal measure of growth for comparison of French fetal size with that of the IG-21^st population. The impact of switching to the IG-21^st fetal growth standards was quantified by comparing Z-scores calculated using the IG-21^st standards with those calculated using locally derived reference ranges for HC, abdominal circumference (AC) and femur length (FL).

RESULTS

Following selection, 4858 cases were analyzed. The distribution of HC demonstrated clear similarity between our French population and the IG-21^st population: our observed centile curves closely matched those of IG-21^st and the Z-scores were close to 0 across gestational age. The IG-21^st standards performed as well as did locally derived charts in terms of screening for small-for-gestational age by AC, while they identified significantly fewer small FL values than were expected and than did the locally derived charts.

CONCLUSIONS

Under strict selection criteria, fetal size in France is similar to that of the international population used in the IG-21^st Project. The discrepancies in FL are unlikely to impact on prenatal management. Therefore, switching from locally derived reference ranges to the IG-21^st standards appears to be a safe option. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.

The significance of spatial memory for water finding in a tadpole-transporting frog

The ability to associate environmental cues with valuable resources strongly increases the chances of finding them again, and thus memory often guides animal movement. For example, many temperate region amphibians show strong breeding site fidelity and will return to the same areas even after the ponds have been destroyed. In contrast, many tropical amphibians depend on exploitation of small, scattered and fluctuating resources such as ephemeral pools for reproduction. It remains unknown whether tropical amphibians rely on spatial memory for effective exploitation of their reproductive resources. Poison frogs (Dendrobatidae) routinely shuttle their tadpoles from terrestrial clutches to dispersed aquatic deposition sites. We investigated the role of spatial memory for relocating previously discovered deposition sites in an experimental population of the brilliant-thighed poison frog, Allobates femoralis, a species with predominantly male tadpole transport. We temporarily removed an array of artificial pools that served as the principal tadpole deposition resource for the population. In parallel, we set up an array of sham sites and sites containing conspecific tadpole odour cues. We then quantified the movement patterns and site preferences of tadpole-transporting males by intensive sampling of the area and tracking individual frogs. We found that tadpole-carrier movements were concentrated around the exact locations of removed pools and most individuals visited several removed pool sites. In addition, we found that tadpole-transporting frogs were attracted to novel sites that contained high concentrations of conspecific olfactory tadpole cues. Our results suggest that A. femoralis males rely heavily on spatial memory for efficient exploitation of multiple, widely dispersed deposition sites once they are discovered. Additionally, olfactory cues may facilitate the initial discovery of the new sites.

Where have all the tadpoles gone? Individual genetic tracking of amphibian larvae until adulthood

Reliably marking larvae and reidentifying them after metamorphosis is a challenge that has hampered studies on recruitment, dispersal, migration and survivorship of amphibians for a long time, as conventional tags are not reliably retained through metamorphosis. Molecular methods allow unique genetic fingerprints to be established for individuals. Although microsatellite markers have successfully been applied in mark–recapture studies on several animal species, they have never been previously used in amphibians to follow individuals across different life cycle stages. Here, we evaluate microsatellites for genetic across-stages mark–recapture studies in amphibians and test the suitability of available software packages for genotype matching. We sampled tadpoles of the dendrobatid frog Allobates femoralis, which we introduced on a river island in the Nature Reserve ‘Les Nouragues’ in French Guiana. In two subsequent recapture sessions, we searched for surviving juveniles and adults, respectively. All individuals were genotyped at 14 highly variable microsatellite loci, which yielded unique genetic fingerprints for all individuals. We found large differences in the identification success of the programs tested. The pairwise-relatedness-based approach, conducted with the programs kingroup or ML-Relate, performed best with our data set. Matching ventral patterns of juveniles and adult individuals acted as a control for the reliability of the genetic identification. Our results demonstrate that microsatellite markers are a highly powerful tool for studying amphibian populations on an individual basis. The ability to individually track amphibian tadpoles throughout metamorphosis until adulthood will be of substantial value for future studies on amphibian population ecology and evolution.

High-resolution forest mapping for behavioural studies in the Nature Reserve 'Les Nouragues', French Guiana

For animals with spatially complex behaviours at relatively small scales, the resolution of a global positioning system (GPS) receiver location is often below the resolution needed to correctly map animals' spatial behaviour. Natural conditions such as canopy cover, canyons or clouds can further degrade GPS receiver reception. Here we present a detailed, high-resolution map of a 4.6 ha Neotropical river island and a 8.3 ha mainland plot with the location of every tree >5 cm DBH and all structures on the forest floor, which are relevant to our study species, the territorial frog Allobates femoralis (Dendrobatidae). The map was derived using distance- and compass-based survey techniques, rooted on dGPS reference points, and incorporates altitudinal information based on a LiDAR survey of the area.

Hepatitis B immunity in teenagers vaccinated as infants: an Italian 17-year follow-up study

We assessed the persistence of hepatitis B surface antigen antibody (anti-HBs) and immune memory in a cohort of 571 teenagers vaccinated against hepatitis B as infants, 17 years earlier. Vaccinees were followed-up in 2003 and in 2010 (i.e. 10 years and 17 years after primary vaccination, respectively). When tested in 2003, 199 vaccinees (group A) had anti-HBs <10 mIU/mL and were boosted, 372 (group B) were not boosted because they had anti-HBs ≥10 mIU/mL (n = 344) or refused booster (n = 28) despite anti-HBs <10 mIU/mL. In 2010, 72.9% (416/571) of participants had anti-HBs ≥10 mIU/mL (67.3% in group A vs. 75.8% in group B; p 0.03). The geometric mean concentrations (GMCs) were similar in both groups. Between 2003 and 2010, anti-HBs concentrations in previously boosted individuals markedly declined with GMC dropping from 486 to 27.7 mIU/mL (p <0.001). Fifteen vaccinees showed a marked increase of antibody, possibly due to natural booster. In 2010, 96 individuals (37 of group A and 59 of group B) with anti-HBs <10 mIU/mL were boosted; all vaccinees of the former group and all but two of the latter had an anamnestic response. Post-booster GMC was higher in group B (895.6 vs. 492.2 mIU/mL; p 0.039). This finding shows that the immune memory for HBsAg persists beyond the time at which anti-HBs disappears, conferring long-term protection.

Screening for fetal spina bifida at the 11-13-week scan using three anatomical features of the posterior brain

OBJECTIVE

To evaluate the contribution of examination of specific anatomical features of the fetal posterior brain on mid-sagittal first-trimester ultrasound examination to the early detection of open spina bifida.

METHODS

Four independent observers reviewed a series of 260 mid-sagittal first-trimester ultrasound images from 52 cases of open spina bifida and 208 normal fetuses. The following analysis was performed by each reviewer for each image: Herman score calculation, intracranial translucency score (CFEF-IT) calculation and determination of presence or absence of three anatomical criteria: intracranial translucency (IT), caudal displacement of the brainstem and cisterna magna. The sensitivity and the false-positive rate for spina bifida detection were calculated for each of the latter three criteria. A secondary analysis was performed on the subset of images achieving a Herman score ≥ 7.

RESULTS

The highest detection rate for spina bifida was achieved by non-visualization of the cisterna magna, with associated sensitivity of 50-73% and 39-76%, respectively, for all images and for the subset of images achieving a Herman score ≥ 7. Posterior shift of the brainstem achieved the highest detection rate (86%), but for a single reviewer only. The level of variation in performance between observers was also greatest for this sign. Absence of IT was associated with a lower detection rate for all observers. Overall, an abnormal posterior brain presenting at least one of these three criteria was associated with a detection rate ranging from 50 to 90%.

CONCLUSION

In the detection of spina bifida, non-visualization of the cisterna magna achieved the best screening performance. Both non-visualization of the IT and posterior shift of the brainstem were associated with acceptable but lower detection rates. A prospective evaluation of changes in the posterior brain is needed to allow assessment of the most pertinent criteria for first-trimester screening for spina bifida.

The Homing Frog: High Homing Performance in a Territorial Dendrobatid Frog Allobates femoralis (Dendrobatidae)

Dendrobatidae (dart-poison frogs) exhibit some of the most complex spatial behaviors among amphibians, such as territoriality and tadpole transport from terrestrial clutches to widely distributed deposition sites. In species that exhibit long-term territoriality, high homing performance after tadpole transport can be assumed, but experimental evidence is lacking, and the underlying orientation mechanisms are unknown. We conducted a field translocation experiment to test whether male Allobates femoralis, a dendrobatid frog with paternal extra-territorial tadpole transport, are capable of homing after experimental removal, as well as to quantify homing success and speed. Translocated individuals showed a very high homing success for distances up to 200 m and successfully returned from up to 400 m. We discuss the potential orientation mechanisms involved and selective forces that could have shaped this strong homing ability.

Visualization of intracranial translucency at the 11-13-week scan is improved after specific training

OBJECTIVE

To evaluate the ability to confidently identify intracranial translucency (IT) in a clinical practice and following specific training of 10 operators.

METHODS

Two experienced observers reviewed 11-13-week nuchal translucency (NT) images for IT visibility in (1) a series of 50 randomly selected images obtained by 10 skilled operators certified by the Collège Français d'Echographie Foetale (CFEF) (retrospective analysis) and (2) a series of 315 images obtained by 10 different operators following specific training for IT visualization (prospective analysis). We calculated proportions of images for which IT was deemed visible and the agreement between the two observers. Data were also stratified by Herman and CFEF quality-score intervals.

RESULTS

In the retrospective analysis, IT was visualized by both reviewers in 52% of images, with a moderate level of agreement (κ = 0.63). The rate of IT visualization by both reviewers increased very slightly to 56-58% when only considering images with the best NT quality-control scores. Following specific training of the operators the proportion of images for which both reviewers could identify the fourth ventricle increased to 85%, but the level of agreement remained moderate (κ = 0.66). When considering images with the best NT quality-control scores, IT visualization by both reviewers increased to 91-92%.

CONCLUSIONS

In a clinical practice that focuses on NT measurement IT cannot be visualized in a substantial proportion of the images obtained, which limits the utility of this approach for the early prenatal diagnosis of open spina bifida. However, the ability to identify the fourth ventricle significantly increases following specific training.

Neurodevelopmental outcome following prenatal diagnosis of an isolated anomaly of the corpus callosum

OBJECTIVES

To assess the ability of prenatal ultrasound and magnetic resonance imaging (MRI) to diagnose isolated anomalies of the corpus callosum (ACC) and to further document the long-term prognosis following diagnosis.

METHODS

This was a prospective case-control study carried out between 1999 and 2004. Diagnosis was made by a combination of ultrasound and MRI. All infants were examined by a neuropediatrician and parents consented to answer questionnaires (CDI, Ireton's Child Developmental Inventory) in 22 cases, which were matched with 44 control infants. The CDI was used to assess neurodevelopmental outcome in cases and controls. Mean DQ-CDI (development quotient calculated from CDI) values and frequencies of abnormal results were compared between groups, and a meta-analysis of previous studies was performed.

RESULTS

The diagnosis of ACC was made prenatally and confirmed postnatally in 175 cases. The diagnosis was thought to be isolated ACC in 88/175 (50%) cases. Sixty of these 88 cases (68%) underwent termination of pregnancy and one died in utero. Twenty-seven were liveborn, of which 26 were followed up for a median of 50 (range, 30-74) months. Additional anomalies were diagnosed postnatally in four (15%) of these 26 neonates. The control group was significantly better (P < 0.05) compared with the cases diagnosed prenatally with isolated ACC with respect to gross motor, fine motor, language comprehension, numbers and general development, and it was marginally better for letters (P = 0.066). Seven of 26 (27%) (95% CI, 13-46%) infants with ACC over the age of 30 months had neurodevelopmental delay, compared with only one case with borderline developmental delay among the 44 controls (P = 0.006).

CONCLUSION

Prenatal diagnosis of ACC by a combination of ultrasound and MRI is reliable. However, the isolated nature of the anomaly could only be assessed in 85% of our cases. Since counseling is provided at the time of prenatal diagnosis, our population of isolated ACC included the cases that were missed prenatally as being ACC with associated anomalies. A meta-analysis of nine studies suggests that the development of children diagnosed prenatally with isolated ACC is normal in up to 70% (CI 95%, 56-83%) of cases. This means that the prospective risk of neurodevelopmental delay for a fetus with ACC described as isolated prenatally is 27%, compared with 15% for an infant whose diagnosis of isolated ACC is confirmed postnatally.

[Outcome of fetuses with malformations discovered before 14 weeks. Where the discovery is revealed by echography during the first trimester, is it responsible for the voluntary termination of the pregnancy? Comparison before and after July 2001]

OBJECTIVES

The aims of this study were to review detection of fetal malformations during the first trimester and to study pregnancy and infant outcomes. We wanted to check if the lengthening of the legal delay for volontary termination of pregnancy changes the outcome of the pregnancy, in cases outside of the legal requirements.

MATERIALS AND METHODS

This study was overseen by the french college of fetal echography (CFEF). All the cases of abnormality detected before 14 weeks' gestational age, excluding the isolated increased nuchal translucency, were extracted from the total population examined, and details were entered into the database of the French College of Fetal Echography. All case records were then analyzed. We compared two populations: before and after July 2001.

RESULTS

We observed 336 fetuses with malformation(s), 108 before July 2001 and 208 after that date. One percent (0.5-1.6) of scans performed between 10 and 14 weeks revealed fetal abnormalities apart from isolated increased nuchal translucency. Of the 336 cases retained for investigation, 109 increased nuchal translucency or hygroma associated with other malformation(s), 103 central nervous system anomalies, 85 malformations of the thoracoabdominal wall, 81 limb abnormalities, 41 had renal malformations, 28 spinal abnormalities, 21 had heart malformations, 16 involved biometric abnormalities, 12 involved abnormalities of the appendages, and 11 facial abnormalities. Medical termination of pregnancy was performed in 75% of cases. Death in utero occurred in 9% of cases, 12% of infants were born alive. In 3.9% of cases, an abortion was performed. There were no differences between both populations before and after July 2001.

CONCLUSION

Excluding isolated increased nuchal translucency or hygroma, malformation before 14 weeks' gestational age was detected in 1% of fetuses. The most common malformations detected in the first trimester were non-isolated increased nuchal translucency and malformations of the thoracoabdominal wall and the brain. The prognosis for fetuses with malformations detected during the first trimester was very poor as only 12% of these infants were born alive, some of them with severe malformations. In our study, and given its limitations, there were no differences between the number of voluntary terminations performed before and after July 2001.

Pregnancy outcome and prognosis in fetuses with increased first-trimester nuchal translucency

OBJECTIVE

One of the concerns of prenatal diagnosis is to find sensitive markers to screen for chromosome abnormalities, such as serum assays or nuchal translucency (NT). This study reports our experience with NT measurement during the first trimester of pregnancy.

MATERIALS

The study was performed prospectively on 252 fetuses with either NT > or =3 mm or cystic hygroma.

RESULTS

We observed 50 abnormal karyotypes, i.e. 19.8%. The incidence of chromosome abnormalities increased with increasing maternal age and increasing NT thickness. For the 202 fetuses with normal karyotypes, outcome was unfavourable in 32 cases: 23 elective terminations of pregnancy, 8 spontaneous abortions and 1 neonatal death. Outcome was favourable in 141 cases. Twenty-nine pregnancies were lost to follow-up.

CONCLUSION

Measurement of NT at 12 weeks' gestation seems to be a good marker for chromosome abnormalities. When the karyotype is normal, the pregnancy outcome remains correlated with the degree of NT thickness. The finding of NT >3 mm between 10 and 14 weeks' gestation dictates rigorous ultrasound monitoring and caution when predicting pregnancy outcome.

Correlation of prenatal MRI and autopsy findings in the diagnosis of vein of galen arteriovenous malformation

SUMMARY

We report the case of an arteriovenous malformation (AVM) of the vein of Galen diagnosed in utero at the 34th week of gestation by ultrasound and MRI. Following interdisciplinary advice, the family decided to terminate the pregnancy. This was carried out in the 36th week of gestation. Mascroscopic study of the fetus confirmed the in utero diagnosis: considerable dilatation of the cerebral arteries, the Galen vein and the anteroinferior sinuses. Based on the correlation of pre and post natal examinations, this study highlights the accuracy of in utero MRI, coupled with ultrasound scanning in the diagnosis of an AVM of the Galen vein. It provides specific information on the degree of cerebral impairment. MRI in utero helps in decision-making for pregnancy termination.

Successful treatment of refractory supraventricular tachycardia by repeat intravascular injection of amiodarone in a fetus with hydrops

We report the case of a fetus with supraventricular tachycardia complicated by congestive heart failure and ascites. After failure of initial transplacental treatment, the injection of amiodarone into the umbilical vein combined with evacuation of ascites achieved conversion to sinus rhythm and restored cardiac function thus allowing pregnancy to go to term. This report suggests that direct fetal therapy by umbilical vein puncture and evacuation of effusions constitutes an effective treatment for supraventricular tachycardias with massive fetal hydrops which do not respond to transplacental treatment.

[The oral status of HIV+ patients. The clinico-statistical results with reference to 2 examination check-ups]

The authors describe experience during 2 cycles of examinations of HIV+ patients in an outpatient department devoted to seropositive screening. The results were statistically evaluated in order to seem up the typical characteristics of oral health in this population.

[Inhibition of the adhesiveness and proliferation of gingival fibroblasts induced by short-chain fatty acids produced by anaerobic bacteria]

Short-chain fatty acids produced by anaerobic bacteria inhibit attachment and proliferation of gingival fibroblasts. Butyric acid, at concentration normally present in periodontal pockets, produced the highest degree of activity.