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DIAGNOSIS
Placenta and membranes, associated with intrauterine fetal demise at 18
weeks -- 133 gram singleton placenta with attached three vessel, 25 cm cord
with area of stenosis of mid-cord (no other pathologic abnormalities
identified.)
CLINICAL INFORMATION
The patient is a 3l-year-old with intrauterine fetal demise at 18 weeks.
GROSS DESCRIPTION
The specimen is submitted as singleton placenta with attached cord and
membranes and consists of a placenta weighing 123 grams. The placental
disc measures approximately 11 x 9 cm with an attached cord measuring
approximately 25 cm in length. One area of narrowing is noted in the cord.
The maternal surface has a normal appearance. No areas suggestive of
infarction are identified grossly.
BLOCK SUMMARY:
Block 1: Sections through area of constriction of cord.
Block 2: Sections through membrane and more normal appearing cord.
Block 3: Sections of placental disc.
Block 4: Section through placental membrane, including area of membrane
with associated fluid present within the membrane.
INTERPRETATION:
Apparently normal male Karyotype.
The positive results listed would indicate a recent fetal maternal hemorrhage
of low magnitude. Using standard calculations based on approximately
average maternal weight and blood volume, the Fetal/|dult RBC ratio
computes a volume of fetal whole blood in the maternal circulation of 2.5 cc.
INTERPRETATION
Maternal peripheral blood is sampled and differentially stained for the
presence of fetal hemoglobin by Kleihauer-Betke technique. Patient's
specimen is examined after appropriately reactive positive and negative
controls were confirmed. A minimum of 2,000 negative staining red cells are
counted along with any positive staining red cells to establish the Fetal/Adult
RBC ratio listed below. The patient's sample demonstrated 1 positive
cells/200O negative cells. Multiple additional low power fields are
microscopically scanned to confirm these results.
AUTOIMMUNE
Tested By: ANW
Cardiolipin Antibody Results Interpretation
Cardiologic IgA 4.90 APL U/ml Negative
Cardiolipin IgG 3.95 GPL U/ml Negative
Cardiolipin IgM 6.74 MPL U/ml Negative
Interpretation: The sample has one copy of the MTHFR C677T mutation
and is negative for the A1298C mutation. This is associated with
intermediate levels of enzyme activity, but no increase in plasma
homocysteine levels. It has not been correlated with coronary disease.
Patient DNA is assayed for the C677T and A1298C mutations in the
methylenetetrahydrofolate reductive gene by polymerase chain reaction
(PCR), and fluorescence monitoring using hybridizatin probes. Sensitivity
and specificity for detection of these mutations are 99.9%.
Normal Results
Protein S Antigen, Free 55-125 69
AT 3 Chm 80-120 88
Protein C Chm 70-130 111