2010-10-06T05:17:24Z

Z3254753: /* Disorders Detected using Amniocentesis */

=Amniocentesis=

=='''Introduction'''==

[[File:Placental_membranes.jpg||thumb|Developing human embryo showing the surrounding amniotic fluid from which the sample is taken.|450px]]
Amniocentesis is the process by which a thin needle is inserted through a womens abdomen into her womb, a sample of the amniotic fluid surrounding her growing fetus is taken out and analysed to acquire information about the baby's health.

This procedure is an important development in the technologies of prenatal diagnostic techniques as it allows parents an insight into possible diseases and complications that their baby might develop before birth at an early stage of its development. Since chromosomal abnormalities occur in 0.1%-0.2%<ref><pubmed>11209176</pubmed></ref> of live births, and the most common abnormality being Down syndrome, amniocentesis provides an opportunity for parents to make informed decisions about their pregnancy and gives them time to consider a number of options.

Although it is a very useful technique in diagnosing up to several hundred fetal complications there are also many risks associated with this invasive method of extraction of fetal cells as well as ethical issues concerning positive results of abnormalities and the possible use of stem cells.
It is shown to be a highly accurate technique but some women may be uncertain about the procedure due to the number of risks and may choose other diagnostic techniques such as chorionic villus sampling.

===Advantages and disadvantages of Amniocentesis===

{|border="1px" cellspacing="1" align="center" cellpadding="5"
|+
! Advantages !! Disadvantages
|-
|style="width:50%"|Gives the baby's sex.

Lower risk of miscarriage than CVS.

Highly accurate, >99.4%.<ref name="PMID989112"><pubmed>989112</pubmed></ref>

Can detect several hundred disorders.

Able to detect chromosomal as well as neural tube defects.

Able to detect if the babies lungs will be mature enough for birth, by measuring the amount of surfactant and phospholipids in the amniotic fluid.<ref><pubmed>15301283</pubmed></ref>
|Risk of miscarriage.

Numerous other risks including infection, harm to the baby during procedure, and anxiety.

Not 100% accurate, there is still a small chance of a false result, false positive or negative for a disorder can lead to undesirable outcomes.

May be seen as an invasive procedure, whereas ultrasound is not.
|-
|}

==Historic Background==

The removal of amniotic fluid using a needle has been recorded as early as 1930 by Menees, however it was not until 20 years later that the process was actually used in a diagnostic sense. The development of safe and effective techniques of the procedure took many years to evolve, including the necessary technologies to come to par such as ultrasound and chromosome mapping that are key features in ensuring safety and effectiveness in diagnosing the fetus.

This progress could not have been achieved without the work of several key scientists:

===Douglas Bevis===

Bevis's study of amniocentesis and hemolytic disease was considered a landmark event making the procedure wide spread and launching more interest and research into its possibilities. In February 1952 he published his study in the Lancet, ''The Antenatal Prediction of Hemolytic Disease of the Newborn''<ref><pubmed>14898745</pubmed></ref> which was a revolutionary article at the time. Bevis experimented with the mixing of Rh+ and Rh- blood and what occurs when there is a clash between the mothers Rh factor and her fetus's Rh factor. This results in hemolytic disease, a disease in newborns where the mothers antibodies attack the fetal red blood cells when the antibodies cross the placenta where they are supposed to strengthen the babies immune system.<ref><pubmed>18730250</pubmed></ref><ref><pubmed>14869844</pubmed></ref> The rhesus factor is present and able to be identified in the fetus from the sixth week of development onwards.<ref><pubmed>4255486</pubmed></ref> The possibility of diagnosing this disorder prenatally was a critical discovery and paved the way for the discovery of hundreds of other disorders which are able to be prenatally diagnosed.

===Murray Barr and Ewart Bartram===
[[File:Barr-murray.jpg||thumb|Dr Murray Barr.|200px|left]]

In the late 1940 's these two scientists began working together studying human sex cells. They discovered in 1949 that the sex of a fetus could be found by identifying an extra chromatin body which lies at the periphery of only female cells, named the Barr body, which is visible under the microscope. The significance of this in relation to amniocentesis as a diagnostic technique is that the possibility of sex linked diseases such as hemophilia, a blood clotting disorder, could be found out prenatally. Murray Barr explains the presence of the chromatin body in his paper ''Prenatal Sex Determination'' written in 1956<ref><pubmed>20325291</pubmed></ref>, however he comments that puncturing the abdomen and uterus of the mother is not worth the associated risks just to determine the sex for the parents curiosity. The associated sex linked diseases which could be more accurately diagnosed prenatally from amniocentesis gave the procedure a truly valuable purpose in giving parents more insight into their babies health and more options in terms of treatment and termination. Until their discovery parents were given statistics based on their family histories of sex linked diseases which were nothing more than loose probability. With the sex of the baby able to be determined more reliable statistics were provided and doctors were able to lay out more options for parents in difficult situations.
[[File:Barr body.JPG||thumb|The presence of the Barr body in female cells.|250px]]
:: '''Case Study''': A case study illustrating the use of sex chromatin analysis in prenatal diagnosis was carried out in 1971 by Ferguson-Smith, Nevin and Stone<ref><pubmed>4255487</pubmed></ref>. In a study of 30 pregnant women, one mother was a carrier of granulomatous disease, a sex linked disease carried on the X chromosome, giving a male fetus a 50% chance of being affected. Sex chromatin analysis showed no presence of a Barr body on the fetal cells, the fetus was thus concluded to be male and the decision was made to terminate the pregnancy 2 days after the amniocentesis procedure. Further chromosome analysis of the amniotic fluid showed an abnormal karyotype resulting in the baby actually having Down syndrome, therefore prenatal sex determination was proved successful, all due to the work of Barr and Bartram.

===Steel and Breg===

In 1966 Steel and Breg worked together studying the analysis of amniotic fluid. They were the first to successfully culture the cells from amniotic fluid and create a karyotype or chromosome mapping of the DNA of the fetus to study its genetic make up. Their study published in the Lancet in 1966, ''Chromosome analysis of human amniotic-fluid cells''<ref><pubmed>4159775</pubmed></ref>, was a major discovery in the progression of amniocentesis as they proved that chromosomal abnormalities are able to be prenatally diagnosed by creating a karyotype of fetus's DNA.

===Timeline for key events in development of Amniocentesis===

{|border="1px" cellspacing="1" align="center" cellpadding="5"
|+
! Year !! Key developments
|-
|style="width:10%"|'''1877'''
|Transabdominal amniocentesis recorded in literature by Prochownick, Von Schatz and Lambl.
|-
|'''1919'''
|Scientist named Hinkel reported the release of amniotic fluid from a pregnant patient suffering from polyhydramnios (The condition of having too much amniotic fluid in the womb).
|-
|'''1930'''
|Reported removal of amniotic fluid using a needle by Menees.
|-
|'''1941'''
|Levine, Katzin and Burham showed that the RhD antigen could cause hemolytic disease and anemia in the child of a pregnant woman.<ref><pubmed>16837685</pubmed></ref>
|-
|'''1949'''
|Murray Barr and Ewart Bartram discovered the presence of a chromatin body on the periphery of female cells that could be used to identify the sex of a fetus.
|-
|'''1952'''
|Bevis's study "The Antenatal Prediction of Hemolytic Disease of the Newborn" was published, landmark event in launching the procedure's credibility, interest and use.
|-
|'''1956'''
|Fuchs and Riis also reported in an article in "Nature" that they could determine the sex of the fetus by the presence of the Barr or chromatin body from cells of the amniotic fluid.
|-
|'''1966'''
|Steel and Breg were the first to create a fetal karyotype from cultured amniotic fetal cells. This work was published in the Lancet, "Chromosome analysis of human amniotic-fluid cells".
|-
|'''1968'''
|Nadler reported the first diagnosis of Trisomy 21.
|-
|'''1972'''
|Brock and Sutcliffe discovered neural tube defects could be diagnosed due to the presence of increased amounts of alpha-fetoprotein (AFP) in the amniotic fluid.
|-
|'''1970'''
|Nadler and Gerbie published the article "Role of amniocentesis in the intra-uterine diagnosis of genetic defects". From this time onwards, laboratories specializing in the analysis of amniotic fluid, including culturing and karyotyping were widespread and the procedure had become very well known and used.
|-
|'''1972'''
|Use of ultrasound to guide the needle was reported by Jens Bang and Allen Northeved. Prior to this amniocentesis was done blind with no visual guidance.
|-
|'''1988'''
|The Benacerraf group reported early amniocentesis procedures being performed (early amniocentesis occurs during the first trimester, to be explained below) however the higher fetal loss rate made this procedure less common and second trimester amniocentesis is now widely used.
|-
|}
<ref>A short History of Amniocentesis, Fetoscopy and Chorionic Villus Sampling, Dr. Joseph Woo. http://www.ob-ultrasound.net/amniocentesis.html</ref>

=='''Procedure'''==

===WHO IS ELIGIBLE FOR THE TEST?===

Since the procedure is invasive and not without a number of risks, the mother is tested before to determine whether she is at a higher risk than average of having a child with a chromosomal or neural tube defect.
These tests include:
* Checking for abnormal ultrasound features.
* Maternal age is considered, women older than 35 are at a higher risk of having children with chromosomal disorders.<ref><pubmed>6220164</pubmed></ref>
* History of chromosomal disorders in the family, testing if the parents are Rh positive or Rh negative.<ref><pubmed>15832534</pubmed></ref>
* History of previous children born with a genetic defect.
* Testing if the mother is a carrier of any X-linked diseases, if so the child may be at an increased risk of inheriting the disorder.
* If the mother is taking certain anti-seizure medications e.g. valproic acid or carbamazipine, this may put the fetus at a higher risk for spina bifida.<ref name ="PrenatalTesting">Prenatal Testing: An Amniocentesis Primer. (2004). http://www.plus-size-pregnancy.org/Prenatal%20Testing/prenataltest-amnios.htm</ref>

===WHEN CAN THE TEST BE TAKEN?===

An amniocentesis test is most commonly performed between weeks 15 to 16 of gestation which is during the second trimester of pregnancy, however it is able to be performed anytime between weeks 14 to 20. Amniocentesis during the third trimester is strongly avoided as there is a high risk of inducing an early labor from premature rupture of membranes within the womb.<ref><pubmed>18191913</pubmed></ref>. Second trimester procedures are preferred over an early amniocentesis which is performed in the first trimester during weeks 11 to 14 as the earlier the test is performed the higher the risk of miscarriage, as much as 3 times greater. The reason an early amniocentesis option is offered to women is since the delay in tissue analysis of about 2 weeks means if an abortion is required it is physically and emotionally easier earlier on in the pregnancy. If an early diagnostic test is requested Chorionic Villus Sampling (CVS) is suggested as it carries less risk of miscarriage and complications than amniocentesis in the first trimester.<ref>Prenatal Testing: An Amniocentesis Primer. (2004). http://www.plus-size-pregnancy.org/Prenatal%20Testing/prenataltest-amnios.htm</ref>

===STEPS OF THE PROCEDURE===
[[Image:Process of amniocentesis.jpeg|thumb|alignment|350px|The amniocentesis procedure showing insertion of the needle into the uterus and use of ultrasound.]]

====Preparation====

* Counseling for the mother is provided to investigate any family history of genetic disorders or any birth defects in previous children. The mother is given an assessment<ref><pubmed>9084385</pubmed></ref> on whether this procedure will benefit her based on her history and likelihood of baring a child with a fetal abnormality. She is also informed of the details and risks of the procedure and is able to make an informed decision to continue or not based on anxiety towards an invasive and risky procedure. <ref>Brajenović-Milić B, Babić I, Ristić S, Vraneković J, Brumini G, Kapović M. Womens Health Issues (2008) Pregnant women's attitudes toward amniocentesis before receiving Down syndrome screening results.PMID: 18180167</ref><ref><pubmed>15284930</pubmed></ref>
* The next step is cleaning of the area before needle insertion with an iodine solution to ensure no contamination.
* Local anesthetic may be administered but since there is little pain it is usually omitted to avoid a second needle insertion.

====Needle Insertion====

* The 20-22 gauge needle is inserted and 15 mL of amniotic fluid is sampled, it takes approximately 30 seconds to withdraw the fluid.<ref><pubmed>8236967</pubmed></ref>
* Before the needle is inserted and whilst the needle is inside the uterus ultrasound is used continuously to ensure no harm is caused to the baby or placenta.
* After the fluid is sampled the baby's heart beat is checked to ensure there was no harm.

====The Amniotic Fluid====
[[Image:Amniotic Fluid Analysis.JPG|thumb|alignment|300px|The process of amniotic fluid analysis in the lab including centrifugation, culturing and karyotyping.]]
* The fluid removed contains fetal cells shed from the skin, and the lining of the gastrointestinal and respiratory tracts.
* These cells which will contain the DNA of the fetus is sent to a lab where it is cultured and the chromosomes are able to be mapped to investigate any chromosomal defects. Protein levels are also analyzed to investigate any neural tube defects.<ref>North East Valley Division General Practice Victoria, Australia.http://www.nevdgp.org.au/info/melb_us/Amniocentesis_melb.htm</ref>

====In the Lab====

* In the lab the amniotic fluid sample is centrifuged to separate the fetal cells from the amniotic fluid containing lipids, proteins, glucose and electrolytes.
* After it is centrifuged the bottom half of the separated fluid containing the fetal cells is immersed in a culture medium designed to maximize colony growth of the embryonic cells. The cells are able to grow and then stored in an incubator until the time comes to harvest them.<ref name="PMID5273905"><pubmed>5273905</pubmed></ref>
* The harvested cells are arrested in the metaphase stage of cell division which is the time of most condensation of the DNA. This means the chromosomes are able to be seen under a microscope after correctly dyed.
* The chromosomes are stained with certain chemicals that bind to the DNA to create a characteristic and recognizable banding pattern that will be different for the varying molecular structures of the chromosomes.
[[Image:Trisomy21female.jpg|thumb|alignment|left|200px|A karyotype of a human female trisomy 21, a chromosomal defect.]]
====Creating a Karyotype====
* The standard way of observing the stained chromosomes is by creating a karyotype.<ref name="PMID5273905 "/> A karyotype is a photograph taken of the chromosomes arranged from largest to smallest non-sex chromosomes (autosomal) numbered 1 to 22, with the 2 sex chromosomes placed at the end. This allows analysis to be done efficiently and any structural abnormalities to be clearly identified.
* Structural abnormalities that may be indicative of a genetic disorder include chromosome deletions, duplications, translocations and inversions.

=='''Risks'''==

There are risks involved in the procedure of amniocentesis. There is a chance, however small, of a miscarriage. As stated before, only certain people should undergo the procedure because of these reasons.

A study undertaken dealt with specifically the performance of the amniocentesis procedure over 4 years. It indicated that the number of pregnancies ending in miscarriage due to amniocentesis is as low as 1 in 1600.<ref>http://www.ncbi.nlm.nih.gov/pubmed/17077226</ref> Also, the number of stillbirths at 32 and 35 weeks is 3%.<ref><pubmed>PMC2464303</pubmed></ref>

This sample space will differ slightly against the actual percentages of the population. What can be observed is that the leading reasons are to find the chromosomal abnormality indicating Down Syndrome and at the request of the mother, possibly due to known family history.

These guidelines allow for properly measuring the risk of the procedure against knowledge that can be gained from it. A doctor or genetic counsellor should be consulted prior to the test.

===Timing===

Amniocentesis should be performed at a time when enough amount amniotic fluid can be taken for diagnosis without affecting the course of the pregnancy. Generally, this is around weeks 15 -19. As indicated under the procedure section. <ref name="PrenatalTesting"/>

Sometimes there might not be enough amitotic fluid available to take for analysis. In this instance, more amniotic fluid may be taken at a later date.

===Infection===

There is a risk of infection with amniocentesis. It is intrusive as it requires contact to be made with the amniotic fluid by a needle through the skin, abdominal wall and uterine wall. The transfer of bacteria can occur if the needle and area of needle insertion (lower abdomen of the woman) are not properly sterile.

This risk is lowered by all persons involved in the procedure properly washing their hands and working in a sterile environment. Swabbing the area where the needle is inserted is the most common method of keeping these areas clean. <ref name="PrenatalTesting"/>

This also leads to the possibility of transfer of blood plasma from the foetus to the mother. This can cause major issues in the instance where the rhesus (Rh) factor of the baby is positive and the mother is negative. The mother may develop antibodies to Rh factor due to blood transfusion or from a previous birth. The mother's antibodies can diffuse through the placenta and cause red blood cell agglutination. This has devastating effects on the development of the foetus. <ref> Principles of Human Physiology(2002) William J. Germann Cindy L. Stanfield </ref>

It is acceptable to use a needle for pain management of the mother during the procedure. The use of two needles generally increases the risk of infection, so it is more commonly practiced that the mother puts up with the discomfort.

[[Image:Ultrasound4.jpg‎ |thumb|alignment|Amniocentesis in first trimester pregnant sheep. The 22 Gauge needle is being guided using a 3.5MHz ultrasound transducer|left]]

===Use of Ultrasound===

Ultrasound is used to show the foetus growing inside the uterus of the mother. The chance of the needle hitting the developing foetus is a risk factor. This can be avoided by constantly using ultrasound to see the position of the developing foetus. The constant vision allows for withdrawing fluid without physically hitting the foetus. It also gives the doctor confidence and reassurance that the needle is in the right place and not causing risk problems.

It also allows the doctor to see that the needle has entered the right area. This reduces the occurrence of piercing other organs such as the bowel, which could lead to infection of the uterus, internal bleeding and other complications which could lead to miscarriage.

===Psychological Risks===

The emotional state of the mother can have affects on the outcome of the pregnancy. During pregnancy, hormone levels in the mother change to maintain the pregnancy, suppressing the degeneration of the endometrial lining which leads to menstruation.

The invasive nature of amniocentesis can invoke conditions such as anxiety in the mother. This can also be brought on by the results of amniocentesis coming back with undesirable results, leading to anxiety and depression.

Cortisol is a hormone produced in the adrenal gland that is triggered by emotional stressors. If it is produced excessively in the mother, some of the hormones can reach the foetus in the uterus. If this occurs there might be developmental effects on the foetus. <ref><pubmed>1694152</pubmed></ref> These include:

• Asymmetry of coordination of fingers, elbows and others

• Mental development

• Imperfections in nervous system

• Decreased perception, thinking and memory abilities

The presence of a partner during the pregnancy has been found to reduce the stress levels of the mother. However, the elevated anxiety levels brought on by amniocentesis were found not to have the same effect. <ref>http://www.ncbi.nlm.nih.gov/pubmed/20401956</ref> Therefore health care professionals must monitor the mother closely for signs of anxiety and help them better cope with the situation to reduce this.

=='''Disorders Detected'''==

There are many disorders that can be found from amniocentesis. These can be either chromosomal abnormalities or neural tube defects. The amniotic fluid sample taken during amniocentesis is centrifuged so the cells are separated from the plasma. From these cells, the chromosomes are able to be observed and from this, chromosomal abnormalities can be seen.

[[File:Abnormal81-92-neuron.png|thumb| alignment=left|Pie diagram shows the percentage of neural defects of all notifiable birth defects in Australia. |300px]]

===Chromosomal Abnormalities===

The genetic disorders are diagnosed using karyotyping. Karyotyping in amniocentesis is taking the cells present in the amniotic fluid sample and mapping out the chromosomes in them. In a human, the normal number of chromosomes is 22 pairs of autosomal chromosomes and 1 pair of sex chromosomes. Doctors looking at these can compare the karyotype of a foetus against the normal karyotype for humans, and diagnose disorders based on these.

These abnormalities arise from errors during either mitosis or meiosis during reproduction. These can be broken down into sub categories based on how the chromosomes are different to a usual set:

''Aneuploidy''

These are the abnormalities where there are an atypical number of chromosomes. There may be the addition or subtraction of a chromosome from any of the chromosome pairs, resulting in an overall net difference between this set and the normal number of chromosomes. They can be divided into 3 categories based on these differences. Relatively common are disorders monoploidy and polyploidy abnormalities.

[[File:Chromosomalabnormalities.JPG|thumb|left|Classification of chromosomal abnormalities|320px]]

The instance where a chromosome is missing from a pair is called monoploidy. This can occur on any of the chromosomal pairs and the effects on development depend on which set it is present. A common example is Turner’s syndrome, where a sex chromosome is completely missing.

Amniocentesis aims to find out whether disorders such as this are present in a foetus, so decisions can be made about whether to go ahead with the pregnancy. Polyploidy occurs when there is an increase in the number of chromosomes in a pair. This is the case in Down Syndrome, where there is an extra chromosome on the 21st pair.

Aside from these, the diploidy case is not abnormal, as this occurs when a pair contains two complete sets of chromosomes. As this leads to normal development, these foetuses do not have a numerical abnormality.

''Structural abnormalities''

Chromosomes are made up of genetic material. Structural defects occur when the size and shape of the chromosome itself is altered. This takes place when changes occur in the sequencing on the genetic material that makes up the chromosomes. The physical placement of genetic material can be altered through such things as deletions, duplications and translocations of base pairs within the sequences of DNA. Changing in the sequence of the DNA within these chromosomes leads to fundamental changes in the growth of the foetus.

[[File:Enencephaly.jpg|thumb|alignment| Anencephaly (congenital absence of brain) in a human newborn baby. Source: Almazi ]]

===Neural Tube Defects===

Neural tube defects arise from abnormal closure of the neural tube during foetal development. They are the most common, occurring in about 1 in every 2000 births. <ref name="PMID11147289"><pubmed>11147289</pubmed></ref> They account for several birth disorders that can be pre-diagnosed using the amniotic fluid. In normal foetal development, the neural tube closes at the cranial and cordial neuropores at either end. The tube should be completely closed at stage 13 (week 4) of foetal development. If this doesn’t happen, any number of problems can arise depending on the type of non closure that occurred. Taking folic acid before conception decreases the reccurance and occurance of NTDs. <ref><pubmed>11147289</pubmed></ref>

Prenatal testing for this involves screening for levels of alpha fetoprotein. This indicates whether complications will rise due to the incomplete closure of the neural tube. Amniocentesis for these types of disorders can be carried out if there are found to be suspect ultrasound readings. <ref><pubmed>9852645</pubmed></ref> AFP levels are generally increased when the neural tube is open but lower than normal with Down Syndrome.

====Disorders Detected using Amniocentesis====

{|border="1px" cellspacing="1" align="center" cellpadding="5"
|-bgcolor="#bbbbbb" border="1px"
|Disorder
|Cause
|Main Caracteristics
|Occurence Rate
|-
|[[ Trisomy 21 | Down Syndrome (trisomy 21) ]]
|The presence of all or a part an extra 21st chromosome
|Mental retardation
Abnormal musculoskeletal development
Particular set of facial characteristics.
|1 per 1000
|-
|[[ Trisomy 18 | Edwards Syndrome (trisomy 18) ]]
|The presence of all or a part an extra 18st chromosome
|Kidney malformation
Structural heart defects
Intestines outside body
Mental retardation

|0.33
|-
| [http://en.wikipedia.org/wiki/Turner_syndrome Turner syndrome (monosomy X)]
|This is several different conditions, the most common is that an entire sex chromosome is missing
|Short stature
Swelling in limbs
Webbed necks
Low set ears

|0.4 of girls
|-
|[http://en.wikipedia.org/wiki/Spina_bifida Spina Bifida]
|Incomplete closure of the embryonic neural tube at the chorionic end
|Baby born with protruding spinal chord
Different levels

|.7
|-
|[http://en.wikipedia.org/wiki/Anencephaly Anencephaly]
|Failure of neural tube closure at the cranial end
|No forebrain
Baby born blind, deaf and unconscious

|0.0057
|-
|[http://en.wikipedia.org/wiki/Fragile_X Fragile X]
|Faulty X chromosome resulting in failure to express an essential protein for normal neural development from the FMR1 gen
|Prominent ears, long face, low muscle tone, atypical social behaviour
|males: 0.27
females: 0.2
|}

==Diagnostic Accuracy==

A correctly gathered amniotic fluid sample of sufficient quantity generally contains shed skin, lung and bladder cells from only the foetus, and therefore should give genetic information pertinant to that foetus alone.
Photographic evidence of the chromosomal arrangement allows future double checking of interpretation.
Accuracy of traditional karyoptyping has been placed at
above 99.4% <ref><pubmed>12968936</pubmed></ref>.
Some studies place this as high as 99.8% accurate<ref><pubmed>18492228</pubmed></ref>.

Molecular technologies such as fluorescence in situ hybridisation (FISH) and
quantitative fluorescence polymerisation chain reaction (QF-PCR) have now become a commonly offered preamble or supportive test to traditional karyotype test (TKT). Due the molecular testing of uncultured amniocytes and the fast turn around time, the results can be available much sooner and are offered to low risk pregnancies, that however warrant further investigation.
A 1993 study of 4550 patients by using FISH analyisis testing for the most common autosomal abnormalities , trisomy 13,18 and 21 (Patau, Edward and Down syndromes respectively) and sex chromosome aberrations,found that the results were 99.8% accurate when checked against cytogenetic results <ref><pubmed> 8488836</pubmed></ref>.
These methods do not however give a full karyotype picture, and are unlikey to replace the comprehensive TKT testing in the near future.

Increasing risk of abnormalities with maternal age (35> yrs), carrier status of gene rearrangement in either parent and visible abnormal structural ultrasound diagnosis may make these molecular methods inappropriate to be offered as they currently cannot detect 20-30% of possible abnormalities <ref><pubmed>17075785</pubmed></ref>. There is debate as to the use of these methods as 'stand alone' tests, but are seen as rapid turn around diagnostic tools that can supplement TDK with a high degree of accuracy.

Due to the highly technical nature of the chromosome banding process and the physician's subsequent interpretation a small percentage of false negative and false positive results may occur. There is the potential for false results due to maternal
blood contamination of the sample, however detection of maternal cell contamination (MCC) in amniotic fluid samples via PCR based assay may be helpful to screen against this<ref><pubmed>< 7897630</pubmed></ref>.

A 1979 study of Canadian genetic centres placed alpha-1-fetoprotein (AFP) testing for diagnosis of neural tube defects 99.2% interpreted accurately for the condition<ref><pubmed>86382</pubmed></ref>.

==Ethical Issues==

The current
Medico-legal stance on prenatal genetic testing sees amniocentesis as permissable according to law.

The risk of induced miscarriage or physical trauma to the foetus has been assessed as existing but minimal, however, such an invasive technique is generally today only offered to women after screening blood tests have made amniocentesis worth the risk to the mother and foetus.

Studies have shown that amniocentesis should only be performed after the start of the 15th week as that performing before this time has significantly higher miscarriage rates than the accepted proceedure related rate of 0.5-1.0%<ref><pubmed>20051662</pubmed></ref>.

Amniocentesis does occur in the first to early trimester in some cases<ref><pubmed>17106178</pubmed></ref>.
Issues of what constitutes an endangerment to the life of the foetus become evident.

Issues of informed consent to the procedure surround any invasive medical procedure.

Towards setting high ethical standards of practice pre and post genetic counselling by qualified staff is made available to anyone undertaking amniocentesis in Australia, monitored by the relevant state health services.

Privacy and freedom of information concerns may raise undue psychological hardships for the mother and therefore raises questions of ethics.
The familial nature of genetic information may then be shared by those involved amongst a family group against an individuals wish.

The existence of proven false positive results in laboratory assays raises the ethical question of the validity of electing
to voluntarily abort the pregnancy. Ethics of being certain of the results arise, for instance if it later becomes known that the results were incorrect, in terms of how will this impact on those concerned.

In Australia in 1969, abortion was not deemed unlawful by the supreme court if it could be proven that the pregnancy was endangering the mother's life or physical or mental health to a serious degree<ref><pubmed>16969440</pubmed></ref>.

This raises questions as to the application of the criteria in favour of termination of pregnancy if Down's syndrome is detected for instance, as compared to a neural tube defect present in the foetus<ref><pubmed>12663637</pubmed></ref>.

How is it defined as to what constitutes an acceptable threat to the mother from a legal and genetic point of view.

Abortion in itself is legal to some degree in many developed countries and the ethical issues involved are
thus limited to personal choice.

==Current Research==

Amniocentesis remains the definitive way to obtain amniotic fluid for genetic testing. Whether amniocytes are to be cultured and examined using G-banding or other faster molecular diagnosis is carried out, the collection of prenatal amniotic fluid will continue to be relevant and necessary to diagnosing foetal genetic disorders.

Current research published in 2002 into non invasive isolation of foetal cells from the maternal blood stream via cell culturing techniques does aim to make the need for amniocentesis unnecessary for this purpose<ref><pubmed>12498422</pubmed></ref>. However it does not state that amniocentesis is likely to become obsolete in the near future.

A 2008 review of available literature outlines that further advancements in non invasive prenatal diagnosis (NIPD) have also looked at targeting and isolating cell free foetal nucleic acids that are present in the maternal circulation for a select few genetic conditions, that may form part of the screening process for Down's syndrome in particular<ref>.<pubmed>18945714</pubmed></ref>.

Amniocentesis would then be requested by a practitioner to provide the conclusive evidence if the screening tests show the possibility of aneuploidy.

==Amniocentesis vs CVS==
[[Image:Gray0034.gif|thumb|Developing fetus in the uterus showing the chorionic villi from which the CVS sample is taken.|400px]]

Amniocentesis and Chorionic Villus Sampling (CVS) are similar diagnostic techniques in many ways and may test for some similar defects. Many women weigh up the pros and cons to both these techniques to make a decision as to which one they are best suited to under their own circumstances.

CVS may be chosen over amniocentesis as the results can be obtained earlier, giving more time to undergo a safer and less painful abortion. Even though CVS carries a higher risk of miscarriage to a common second trimester amniocentesis, it is safer and carries a lower risk of miscarriage than a first trimester early amniocentesis. So for many women if an earlier test is required, CVS is usually the preferred choice.

However, amniocentesis has a number of advantages. It is able to detect neural tube defects as well as chromosomal, it is more commonly performed and more physicians are familiar with the procedure, it can detect the maturity of the babies lungs as well as the sex of the fetus.

Some similarities and differences are listed below:

{|border="1px" cellspacing="1" align="center" cellpadding="5"
|+
! Similarities !! Differences
|-
|style="width:50%"|Test is taken for the same reasons:
* Older maternal age
* Abnormal results in other screening tests e.g. ultrasound
* History of chromosomal disorders in the family
* Previous child with a genetic defect

Samples are taken using a needle.

Ultrasound guidance is used to prevent harm to the baby, placenta or mother.

There is a small chance that the results are difficult to analyze and obtain conclusive results and the test may need to be repeated.

Risks are present and may include infection, miscarriage, pain and possible leakage of fluid.

Are both invasive techniques.

Counseling is provided prior to assess the need for the test, the risks and whether the mother is sure she wants to continue.
|Carry different risks of miscarriage:
* CVS = 1-2%
* Amniocentesis = less than 1%
CVS has a higher miscarriage risk since it is performed at an earlier stage of pregnancy.

Are performed at different gestational weeks:
* CVS = between weeks 10-12<ref>Prof Kristine Barlow-Stewart, Mona Saleh. Prenatal Testing – CVS and Amniocentesis (2007). http://www.genetics.com.au/pdf/factsheets/fs17c.pdf</ref>
* Amniocentesis = commonly between weeks 15-16

CVS is preferred by some women since the earlier procedure and results time will allow more time to make a decision about abortion

Different fluids are sampled, one being amniotic fluid, the other being a sample from the chorionic villi of the placenta.

Amniocentesis is only performed by a transabdominal procedure, CVS may be performed this way or through a transcervical technique where the needle is inserted through the vaginal opening and into the womb.<ref name="PMID8236967"><pubmed>8236967</pubmed></ref>

Accuracy:
* CVS = 99.7%<ref name="PMID8236967 "/>
* Amniocentesis = >99.4%

Sample sizes:
* CVS = 10-20mg<ref><pubmed>8236967</pubmed></ref>
* Amniocentesis = 15mL
|}

==Useful Links==

'''More on Amniocentesis''' [http://embryology.med.unsw.edu.au/Defect/amniocentesis.htm UNSW Embryology: Prenatal Diagnosis - Amniocentesis]

'''Animated video of the procedure''' [http://www.youtube.com/watch?v=K9itd1Ot-kg Video of Amniocentesis]

'''Ultrasound video of procedure''' [http://www.youtube.com/watch?v=HNDoYjXgm30&feature=related Ultrasound of procedure] ''Note:''You can see the needle insertion through the wall of the abdomen and uterus towards the top of the screen above the baby.

'''More images''' [http://www.google.com.au/images?hl=en&q=amniocentesis&um=1&ie=UTF-8&source=univ&ei=LDudTPPzA4e4vQP96pX-DA&sa=X&oi=image_result_group&ct=title&resnum=4&ved=0CDUQsAQwAw&biw=1024&bih=436 Google images of amniocentesis]

==Glossary==

'''Agglutination''' - Term used to describe clumping together. Can be used for the changes that occur following sperm ejaculation or an immune response involving antibodies.

'''Allopolyploidy''' - A type of polyploid condition where the extra chromosome arises from a different species.

'''Amniocentesis''' - A prenatal diagnostic test involving sampling of amniotic fluid by needle aspiration for genetic analysis.

'''Amnion''' - An extraembryonic membrane ectoderm and extraembryonic mesoderm in origin and forms the innermost fetal membrane, produces amniotic fluid. This fluid-filled sac initially lies above the trilaminar embryo disc and with embryoic disc folding this sac is drawn ventrally to enclose (cover) the entire embryo, then fetus.

'''Amniotic cavity''' - The fluid-filled (amniotic fluid) extraembryonic coelom (cavity) formed initially by epiblast and then ectoderm and surrounding extraembryonic mesoderm. In humans, it forms the innermost fetal membrane, produces amniotic fluid expanding to fuse with the chorionic membrane during week 8 of development. This fluid-filled sac initially lies above the trilaminar embryo disc and with embryoic disc folding this sac is drawn ventrally to enclose (cover) the entire embryo, then fetus.

'''Amniotic fluid''' - The fluid that fills amniotic cavity totally encloses and cushions the embryo. This fluid is sampled in the prenatal diagnostic test amniocentesis.

'''Aneuploidy''' - Atypical number of chromosomes.

'''Antibody''' - Produced by the body and circulated to protect against antigens. They form part of the immune response of the body.

'''Autopolyploid''' - Type of polyploid. Arises when a pair has more than two sets of chromosomes as a result of redoubling.

'''Cell culture''' - The maintenance or growth of dispersed cells in a medium after removal from the body. <ref>The Free Dictionary. (2007). http://medical-dictionary.thefreedictionary.com/cell+culture</ref>

'''Centrifuge''' - Any of various rotating machines that separate liquids from solids or dispersions of one liquid in another, by the action of centrifugal force.<ref>The Free Dictionary. (2007). http://www.thefreedictionary.com/centrifuge</ref>

'''Chorionic villus sampling''' - (CVS) The taking a biopsy of the placenta, usually at the end of the second month of pregnancy, to test the fetus for genetic abnormalities.

'''Chromatin''' - A diffuse material within the nucleus of a non-dividing eukaryotic cell; consists of DNA and proteins.

'''Chromosomes''' - Double stranded DNA coiled around histones. Condenses during mitosis and meiosis.

'''Deletion (chromosomal)''' - Part of the genetic material making up a chromosome is deleted. Results in frameshift errors and a decrease in genetic material.

'''Duplication (chromosomal)''' - Part of the genetic material is copied, increasing the amount of genetic material in a chromosome

'''Diploidy''' - Describes a diploid cell. This is a cell that has 2 complete chromosomes in a pair.

'''Endopolyploidy''' - A type of polyploidy which comes from the replication of chromosomes without division of the cell nucleus.

'''Fetus''' - In mammals, term describes the period of development following the embryonic period. In humans, the development week 9 to 36 is the fetal stage (second and third trimester). (see fetal period above). This term is also used non-scientifically to describe the human conceptus at both embryonic and fetal stages of development.

'''FISH''' - Abrev. Fluorescent In Situ Hybridisation. A Molecular genetic diagnostic test.

'''Gestation''' - The period of time from conception to birth. A pregnancy with multiple fetuses is referred to as a multiple gestation.

'''Inversion (chromosomal)'''- Genetic material within a chromosome breaks off and reattaches upside down relative to the DNA sequence. This is a chromosomal abnormality.

'''Isochromosome''' - A chromosome that has lost a complete arm and replaced it with an exact copy of its other arm. this forms a mirror image at the centromere.

'''Karyotype''' - Term used to describe the chromosomal (genetic) makeup (complement) of a cell by the number and appearance of chromosomes.

'''Metaphase''' - One of the 5 mitosis phases (prophase, prometaphase, metaphase, anaphase, and telophase) of nuclear cell division, generating two diploid daughter nuclei. Originally based on light microscopy of living cells and electron microscopy of fixed and stained cells. At metaphase kinetochore microtubules align chromosomes in one midpoint plane. Metaphase ends when sister kinetochores separate.

'''Mitosis''' - The normal division of all cells, except germ cells, where chromosome number is maintained (diploid). In germ cell division (oocyte, spermatozoa) meiosis is a modified form of this division resulting in reduction in genetic content (haploid). Mitosis, division of the nucleus, is followed by cytokinesis the division of the cell cytoplasm and the cytoplasmic contents. cytokinesis overlaps with telophase.

'''Monoploidy''' - The condition where a chromosome pair is missing one chromosome.

'''Polyhydramnios''' - The condition of having too much amniotic fluid in the womb, the peak should be 800-1000mL, which may increase to as much as 3 times the amount with this condition.<ref>Baby Center (2008). http://www.babycenter.com.au/pregnancy/complications/polyhydramnios/</ref>

'''Polyploidy''' - The condition where there is more than 2 chromosomes to a pair. This is a numerical abnormality.

'''Prenatal diagnosis''' - any of the diagnostic procedures used to determine whether a fetus has a genetic abnormality.

'''Rh factor''' - The protein on surface of red blood cells in some blood types (Rh+) and absent in others (Rh-). Can cause erythroblastosis fetalis in second pregnancy if fetal/maternal blood of opposite groups mix on first pregnancy.

'''Rings (chromosomal)''' - Occurs when genetic material which is part of a chromosome breaks off and fuses end-to-end with itself, forming a ring.

'''Second trimester''' - Clinical term used to describe and divide human pregnancy period (9 months) into three equal parts of approximately three calendar months. The first trimester corresponds approximately to embryonic development (week 1 to 8) of organogenesis and early fetal. The second and third trimester correspond to the fetal period of growth in size (second trimester) and weight (third trimester), as well as continued differentiation of existing organs and tissues.

'''Stillbirth''' - A fetus or infant delivered without signs of life after 20 weeks or more of gestation.

'''Transabdominal''' - Insertion of the needle across the abdominal wall or through the abdominal cavity.<ref>The Free Dictionary (2007). http://medical-dictionary.thefreedictionary.com/transabdominal</ref>

'''Translocation (chromosomal)''' - A genetic abnormality where genetic material is swapped between chromosomes.

'''TDK''' - Abrev. Traditional Karyotype. Cytological diagnostic testing of chromosome.

'''Ultrasound''' - A non-invasive technique for visualizing and prenatal diagnosis of several features of development including: follicles in the ovaries, the gestational sac, fetus in the uterus, fetal parameters, and the placenta. The technique uses high-frequency sound waves that are reflected off internal structures. These reflections can then be analysed and displayed by computer. Modern ultrasound machines can also carry out 3 dimensional reconstructions and measure "flow" (blood) using doppler measurements.

'''X linked''' - Term used to refer to genes, and genetic diseases, located on the X chromosome. Therefore more likely to be expressed in males, where there is only a single maternal X chromosome.

==References==

<references/>

{{Template:Projects10}}

Talk:2010 Group Project 3

2010-10-06T04:57:51Z

Z3254753:

--[[User:Z3254753|z3254753]] 04:57, 6 October 2010 (UTC)

hey, nice pic 312, hopefully permission comes through soon

--[[User:Z3292208|z3292208]] 04:31, 6 October 2010 (UTC)

What did i say that wasnt nice? Anyways yeah that picture looks good for your section, it would go well with your info. Hopefully you can get the permission.

312

so whats the answer then ?

--[[User:Z3254753|z3254753]] 04:05, 6 October 2010 (UTC)

thanks tegan =)

--[[User:Z3129413]] 03:58, 6 October 2010 (UTC)

312

anyone there ? alrighty... now look at Fluorecent in situ hybridisation on wikipedia you will see a picture of glowing chromosomes .. I am asking permission to use this on the page right now ... actually not just this picture but a few other ones that are bigger.

--[[User:Z3292208|z3292208]] 02:22, 6 October 2010 (UTC)

Hey also guys this is a link to the marking criteria and main points we need to have in the assignment so check it out and see if there's anything that needs fixing or adding?

[[2010 Lab 1|Marking criteria]]

--[[User:Z3292208|z3292208]] 02:16, 6 October 2010 (UTC)

312 said he'd be on top of it all by 2200hr today. uuum yeh i dunno what pictures would fit, maybe some sort of graph about the accuracy over time or compared to other techniques would be awesome but it takes time getting permission and its the day before so not sure what to do.

How to reference with multiple instances on a page is all on this page: [[References]]

--[[User:Z3254753|z3254753]] 00:00, 6 October 2010 (UTC)

Also, we should think bout maybe adding a picture or two to 312's sections. Thing is, its hard coming up with ideas of pictures that are relevant :S can u guys think of anything?

How do I reference the same thing in different parts of the page?

--[[User:Z3254753|z3254753]] 23:36, 5 October 2010 (UTC)

Yup no worries. Ive got info there already on miscarriage, il move it around a bit and add to it. Good thinking about this as a key difference. Ill probly have it as my first sub heading.

Ive bin looking into my chromosomal abnormalities section, different sources say different things about catagorizing conditions, gotta make sure its all correct :S

thanks tegan

--[[User:Z3292208|z3292208]] 22:25, 5 October 2010 (UTC)

hey amniocentesis was the main heading of the page lol so i left that and the intro at the top, and moved the comparison with CVS to the bottom of the page as a wrap up i guess.

hey also mark are you gonna put an extra subheading in risks for miscarriage? i reckon it'd be good to highlight that risk as its one of the main ones you read about and that links into the comparison with CVS as thats one of the points that differs them. what do you reckon?

--[[User:Z3254753|z3254753]] 09:02, 5 October 2010 (UTC)

heya, how do u guys feel about putting amniocentesis after current research? i think itll b a great way to "end" the page, comparing this with cvs.

What do u guys think? i cud b way off on this one haha

--[[User:Z3254753|z3254753]] 05:01, 5 October 2010 (UTC)

yea gud thinking, il redo mine, n add a few more n base it on mark hill's, then reference elsewhere if needed.

--[[User:Z3292208|z3292208]] 00:09, 5 October 2010 (UTC)

I took glossary terms from Mark Hills glossary on this website, other terms i took from the internet and referenced, i think thats better to do and its not hard.

have a look at other groups pages to see their copyright statements to get an idea maybe?

--[[User:Z3254753|z3254753]] 21:33, 4 October 2010 (UTC)

hey 312, im pretty sure u hav to provide the statement, or give the details of its copyright which shows u can use it legally.

in the glossary it seems we can use our own words as long as its clear? wat do u guys think? i think is a good idea, it will show we actually do kno wats going on.

honestly, i was a little surprised to get an email back, she got back to me within a couple of days. But, she sed it was fine, thanked me for asking n wished me all the best haha

mark

--User:Z3129413.
yeah Bro that's awesome (about getting the written permission), did it take long to get a reply? My question for the moment is how to format the copyright info in the statement box, like if its an Image off wikipedia and it has those copyright statements GNU and commons and all that do I have to actually provide an as is copy of that statement ? Its damn hard to find free technical genetic/cytology pictures. I will figure it out anyhow.

That's a very good question about glossary defs, whats the go? maybe we should ref those as well? seems excessive, format the explanation in terms of what is already been referenced in the main text.

Im going to work towards 1500hr Wed as everything pretty much wrapped up for me, with time to change things around till about 2200.

--[[User:Z3254753|z3254753]] 11:50, 4 October 2010 (UTC)

do we make up glossary definitions ourselves?

--[[User:Z3254753|z3254753]] 08:54, 4 October 2010 (UTC)

hey guys, sorry bout the late reply, i just got bak from work.

yup, i will do the copyright n summary for the tree diagram, one of my pictures i got written permission, i emailed prof. anne david, is the copyright info for that ok?

mark

--[[User:Z3292208|z3292208]] 06:36, 4 October 2010 (UTC)

You have to add a copyright statement if its from another website or if its one of your own pictures, all the details are on the editing page:

[[Editing Basics]]

I think its due thurs, not 100% sure.

--[[User:Z3129413]] 06:29, 4 October 2010 (UTC)
yeah thanks bro, 325 ... the copywrite statement that is contained on wikipedia when one clicks on the image is that what we have to include in the summary... hey did you actualy get written permition for the use of one of your images 325 ? thats awesome.. alrighty so the page is due on thurs is it not?

--[[User:Z3292208|z3292208]] 06:17, 4 October 2010 (UTC)

Hey also for the picture you uploaded when you click on it you can add a description there for it and also you need to add a copyright statement, have a look at my diagrams and copy it off that.
Disorders is looking good, the detail is good.

--[[User:Z3254753|z3254753]] 10:07, 3 October 2010 (UTC)

haha no worries tegan, im also redoing the abnormalities so theres more in the paragraphs, kind of expanding on the tree diagram
il hav all my upadtes, n more referencing by either late tonight or tomo =)

mark

--[[User:Z3292208|z3292208]] 10:03, 3 October 2010 (UTC)

Hey mark the tree diagram is good but make it a bit bigger on the page? and yeh put the terms in the glossary.

--[[User:Z3254753|z3254753]] 00:27, 3 October 2010 (UTC)

hey current research is good =) u know what I just thought, this section is a great place to have some external links, maybe to a couple of different research reserach teams websites or something. What do you think?
N its meant to be for the peer level, so im sure its fine to go a bit deeper if u think u need to.

also, im making a tree diagram with pretty technical terms, should i emplain the terms here or just put their definitions in the glossary?

n thats unlucky bout the saints, dw, im sure ull get them next yr =)

z3129413

I like the amnio vs cvs discussion
I dont know but are abortions painful? increasing by degrees of lateness of pregnancy increasing safety (true?) but does this also mean that abortion is less painful the earlier it is done?
I think they mean that amniocentisis is an invasive procedure because it is physicaly sticking a needle into someone, not
invasive as in 'intruding on privacy'.
I am going to put a few pictures up tonight.
Can I have some feedback on the current research section please? too brief ?, If page is supposed to be for the layman then current research is going to get pretty technical from here on in.

--[[User:Z312941]] 09:22, 27 September 2010 (UTC)

Nah Mark told me anyhow about the extension, I just didn't really believe it sorta you know.. Anyhow Saint Kilda possibly winning the Grand final was far more interesting than pretending this web page actually means shit. Tell me what have you actually learnt yourself about current and future trends in genetic testing ? Oh that was my topic.. but what did you learn ? did you bother to get on pubmed and follow all the twists and turns of the articles to understand where its all at now ? you did ? .. then why aren't you
going
Hey I read this fantastic thing on FISH or what ever the other night.. man its got me buzzed... yknow.. that would be more fun.. see this is the problem with university these days its all about missing the big picture for a lot of people. Anyway you are my colleague, we are friends, I am always ready to talk about science and football. This page will get done, and on and on it goes. I learnt a heap out of it. hope you did too. The instructor said it was a lot of fun and for me it was. I am really glad I now know how to use pubmed and stuff because now I can get on with learning stuff for myself which is fun. I didn't disappear who ever you are 3292208... I was on call - I actually am on call most of the time... you will get a job some day and enjoy being on call too, way the world is....

Hey yeah scientific feed back sure that's groovy... whatya know?

I have seen the sources you might have used for your sections and basic stance it was all pretty much ladle from one pot to the other no? maybe we can make that less not subtle.

Anyhow I do have a few little cool bits to add to my sections and all will see what you have when you have it all there and happening..

hey Uni is fun no?

--[[User:Z3292208|z3292208]] 22:41, 26 September 2010 (UTC)

thanks for finally putting your sections up, very very relieved! But i totally forgot to tell you after you disappeared in the lab last week Mark H told us he extended the deadline for a week or so. But i guess its a good thing i forgot to tell you since you did it last minute again now we at least have time to read through it and give you some feedback and finish doing some final touch ups to the page. And now you have time to get some good pics up on your section. I definitely think it would be good to break up the text with pictures, it makes it alot more accessible as a web page.

--[[User:Z3129413]] 22:05, 26 September 2010 (UTC)
well there you go, got it done grand final and all Go the Saints ! Anyway at the expense of looking like I havent wrote too
much I have yes kept it brief.. What is there is many hours of reading pubmed papers the information is factual... Anyone want to chuck in a Fluorescent in situ hybridisation picture in my diagnostic accuracy section for me, that would be really excellent but its hard to find a free one... picture of blue and green glowing chromosomes... you guys have done a really good job... I think it all works together... I was planning on doing a bit more
at lunch time today... is that passed the cut off? I will read this again at about 11 30.. will try to find a few more pics. I put a few things in the glossary.
I think anyone can understand what amniocentesis is about from the page,... I sure do not want to hear that word for a very long time now. Its not too technical.. Good work.

--[[User:Z3292208|z3292208]] 09:14, 26 September 2010 (UTC)

Hey guys just a reminder to add any scientific words to the glossary at the bottom of the page. Also yeah i think we should aim to make this accessible to someone without a background in embryology or even science, so keep it clear, concise and easy to understand :)

--[[User:Z3254753|z3254753]] 13:54, 25 September 2010 (UTC)

,thanks heaps for the suggestions, il work on it =) i thought i did include how rarely problems occur?

i dont think we should include expenses or talk about state health care.

time delay n intro suggestions are both really good.

types of infections are good, but do u want me to go that technical?

i found iodine to be mostly used, but il include the ones, also a good idea, thanks.

glossary is where we will define terms

hopefully u can upload ur sections soon.

Here is one last thing to note; I dont know if u guys were there, but i talked to dr hill after the last lab and he was clear about these things; keep it clear, concise and dont make a 5000 word page for the sake of it, we will get marked down.

I really like what weve done, i think we'll hav an impressive project =)

Mark

--[[User:Z3292208|z3292208]] 01:10, 25 September 2010 (UTC)

Hey also guys you should both check this site out

http://www.plus-size-pregnancy.org/Prenatal%20Testing/prenataltest-amnios.htm

Mark i know you used it for part of your risks section but there's more detail on the site that you could add to your section, i just pulled some more detail off it for my parts.

Also there's some good information on that site for ethical issues and accuracy which you should really check out!

Tegan.

--[[User:Z3292208|z3292208]] 09:04, 24 September 2010 (UTC)

* So you want me write more specifically what type of needle they use?
* I dont know what you want us to write in the introduction, can you explain it better?
* I dont think we should down play the risks, the risks are there no matter how often they occur, we need to explain them, then its our job to show how reliable the procedure is in DIAGNOSTIC ACCURACY. We can say that its relatively safe compared to the other techniques, although there is a small chance of complications due to these risks, and outline them.
* When you talk about "how many cases of deaths from infections..etc" do you think we should write for each risk the occurence rate of them? That could be something worth looking into. Of course all invasive procedures have a risk of infection, and yes the chance of the fetus getting hit by the needle is small (since they use ultrasound) we still need to mention and explain all the possible risks.
* I mentioned in my procedure section that there is a delay in recieveing the results, read through it.
* For those terms mentioned = aneuploidy, trisomy etc, i said we are adding a glossary to the bottom of the page. Feel free to contribute terms from your section, when it is up.
* "We should mention somewhere that Gammaglobulin must to be given to at risk rhesus factor mothers in regard Kleihauer." What does this sentence mean?
* For diagnostic accuracy i think we should mention the possibility of false results - false positive or false negative results. The outcomes of these could be discussed in ethical issues - i.e. a mother aborting a pregnancy thinking there is an abnormality, or a mother not terminating the pregnancy thinking there are no defects, but the baby is born with a disorder.
* Also for diagnostic accuracy, the one reference that is there is from a study of a second trimester amniocentesis, although some are performed during the first trimester, so maybe see if the accuracy is different for the 2? Also it would be good to show trends in accuracy over time, has it improved since the use of ultrasound in the 70's?

Tegan.

--[[User:Z3129413]] 04:02, 24 September 2010 (UTC)
Hello friends so lets get this scene
together and make it groovy for Monday,

Typos and my syntax suggestions for
approval:

format: as is vs (suggestion)

Thin needle (hollow amniocentesis needle of commonly of between 21-22gauge at 120, 150, 90 mm length, there are pictures of these and a 10cc syringe)

Lets say straight off in the intro something like
(following routinely offered prenatal screening blood tests, FTS 10 weeks to 13 weeks 6 days of pregnancy and ultrasound or if missed Second TS blood test 14 to 18 weeks of preg,
diagnostic tests such as amniocentesis can be elected by mother although this is invasive etc
it is highly accurate, refs etc department of health)

I don't know it could be my interpretation but can we downplay the risks associated as the studies
I have read have put amniocentesis when performed with care as really safe

Numerous risks (sounds too broad as infection, harm to the baby (lets use the word foetus) and anxiety
(do you mean also pain to mother)is only three.

How many cases of deaths form infections resulted from amniocentesis are there, a few, many,
proven nosocomial contamination from non sterile equipment,
would this relate to the factor of state of health care available
as opposed to amniocentesis being risky per se,
statistics of proven foetal deaths from skin flora contaminating the womb.

What are the names of skin flora potential pathogens, throw a few of those term around cant hurt, staphylococci, MRSA
gets back to state of health care facilities.

But all invasive procedures by default are risky in terms of infection.

Could we change the use of Iodine solution to simply say area is (stringently disinfected) although I have
read many blogs etc and web pages that have mentioned Betadine, Iodine etc, but I do not know what is used routinely these days with the advent of new hospital pathogens, from my micro experience and having needles they use alcohol swabs, not much grows in that kind of alcohol. We cant say for certain that only Iodine solution can be used before amniocentesis, unless you know otherwise of course, something like that is used before surgery so it might be absolutely correct to say so but this would need references.

I read a web page that outlines the physical trauma that has been caused very unfortunately and I would say
mostly blamelessly to the technicians of such things as foetal optical penetration by the 20gauge needle,
but this is very rare, it doesn't happen everyday, amniocentesis is safe.

Even a minute chance of physical harm to the foetus is enough to blow most peoples minds though, but the Dr is trained to guide a patient through all that.

Seems the big two are chance of miscarriage (minor) and pain of the needle.

Do we mention anaesthesia enough,

How do we rate amniocentesis in terms of risk compared to other invasive diagnostic proceedures.

Anyhow here's a start whilst Im putting my stuff together,
will check back in awhile

This is what I mean by simplistic.

there's typos here and there also.

Peace.

also do we mention to date there is a time delay in getting results, expense of getting results, substantial technical expertise needed by cytogenetics laboratory to perform tests

I think we want to add trisomy 13. as pubmed in 'Future of prenatal cytogenetic studies,rapid aneuploidy testing or full karyotype- a study
13, 18, 21 testing due to this constituting 65-85% of all chromosomal abberations

In disorders detected can terms aneuploidy be defined, can trisomy, monosomy be stated

In diagnostic accuracy we have
Traditional cytogenetic techniques that I will outline and how amniocentisis is important in
providing the material for these tests which gives I would say has the 94% accuracy for diagnosing aneuploidy

vs

The new wave of QF- PCR testing that gives I think about a 97% diagnostic accuracy
A traditional full karyotype can be done or a shortened test is an option, giving quicker turn around times with less expense and anxiety in anticipating results.
so that's the progress that accuracy is taking.
Diagnosing amniotic fluid for genetic aneuploidy is the gold standard.

Current research will be the increasing interest in using PCR techniques.

Mentioning Stem cell research is too off track

The ethics section will be broken into

.Due to the offering of this invasive proceedure
Anxiety to mother due questions of whether it is right or wrong to undergo amniocentisis
from the perspective of procedural potential harm to foetus, and
termination of pregnancy, information gained leading to opening option of abortion.
I will state the current laws that govern current medical actions, such as
the need for the provision of genetic counsel.

We should mention somewhere that Gammaglobulin must to be given to at risk rhesus factor mothers in regard Kleihauer.

Check in with you later tonight or tomorrow.

--[[User:Z3292208|z3292208]] 00:42, 24 September 2010 (UTC)

Hey guys so this is what i think we should change for the final assessment:

# Glossary
# More referencing throughout.
# Add some external links if we find some good sites, or to a video.
# Add a timeline to the history section.
# Add a tree diagram to the disorder section.
# Add a section comparing all the techniques.
# Diagnostic accuracy needs to be added to.
# Ethical issues needs to be broken down from a large paragraph and referenced, and made more clear.
# Current research needs to be added to.
# Look into getting some more pictures.
# Some more risks could be added to the risk section.

What do you think? Did i miss anything, you think thats all we need to do?

Hey also i changed the headings in the page from bold to actual subheadings so that they all show up in the contents at the top of the page.

Just putting this here for myself:

http://www.ncbi.nlm.nih.gov/pmc/articles/instance/1011338/

http://www.genetics.com.au/pdf/factsheets/fs17c.pdf

Tegan.

Thankyou!! :) - Jill --[[User:Z3265772|z3265772]] 11:58, 23 September 2010 (UTC)

--[[User:Z3292208|z3292208]] 02:57, 23 September 2010 (UTC)

Hey Jill yeah sure you can use it, as long as you reference me as the artist! yeah i think thats a good idea too adding a comparison between the different techniques, we're definitely gonna add something similar. enjoy :)

Hi Guys! I was just wondering if i could please get your permission to use your student drawn diagram, if you see our [[2010_Group_Project_2|page]] im making a table with all our diagrams in it, and, of course, i need your permission to use it :) Thanks! Jill - group 2 --[[User:Z3265772|z3265772]] 02:53, 23 September 2010 (UTC)

==Peer review==

Group 3: I thought your page was very thorough and informative especially the procedure section, plus the way in which you have structured the information with concise subheadings keeps it easy to understand. Only thing is that the page lacked a glossary section which would really help the reader understand the concepts better if added. A very good use of table and pictures throughout to keep the content engaging all the way through. To improve the page, perhaps you could talk about the advantages of amniocentesis and even compare it to other techniques. Maybe you could also expand the section on current research by exploring the future prospects of this technique? but overall really good effort.
--[[User:Z3293029|z3293029]] 15:15, 22 September 2010 (UTC)

Group 3 - significant research into your topic evident on the page, so well done. The Abnormalities table is both concise and informative. The table along with the hand drawn images and other images makes the page more aesthetically appealing to the reader. I learned quite a lot about this procedure in one sitting which is a credit to your work.
A few improvements would be to reference the Ethics and the Disorders Detected sections, maybe break up the text with the use of more tables and dot points which would simplify the content a little as it appears to be very technically dense. A glossary would help your audience in understanding the content more easily and maybe adjusting the jargon so that it's not so scientific but more conceptual. Again, like others have mentioned, some editing in terms of grammatical and spelling errors is needed throughout the page. Good effort. --z3241780 13:53, 22 September 2010 (UTC)

'''GROUP 3: Amniocentesis'''

This project is the probably in my opinion the most scientific of all the project pages, but there are point where I felt that if I didn’t have an academic science background I would have got lost. Yet the information presented on the webpage is extremely informative and the structure of the page makes it easy to follow. Referencing for the first few sections is fine but towards the end I find that there are not as many references. The pictures which include the hand drawn pictures are really good and they help break the information into smaller section allowing time to process the information above. Like every other group there are a few spelling mistakes here and there but like I’ve stated on everybody’s pages you will pick them up on your final check. As well I noticed that you don’t really have a proper glossary and I think putting one in would be beneficial but this is just a small suggestion. Apart from that I can’t criticise the assignment. I personally think after reading your assignment the standard of my groups’ assignment should be lifted. You can really tell you have put in a tonne of effort. Well Done Guys!!!

--[[User:Z3252635|z3252635]] 13:22, 22 September 2010 (UTC)

Hi guys!

You have a great distribution of your pictures around the page, it really breaks up the text and makes it easier to read and to look at. I noticed a few spelling/grammar errors throughout your page, though (e.g. “likelihood of baring a child” – it should be bearing) so you might want to proofread it a couple of times. It would make your text easier to read, too – your information is great but sometimes I had to read over bits a few times where the grammar was a little fuzzy. I think you’ve used the table really well to describe disorders detected by amniocentesis. Also, good job of putting the copyright statement with your student-drawn diagrams. Well done!--[[User:Z3252833|z3252833]] 12:44, 22 September 2010 (UTC)

Group 3 = I really like the photos used especially the hand drawn ones and they project is very easy to read and follow. There are alot of references which indicated some serious research .

What could be improved - although everything is already beautiful glossary and timeline(for history)would be better..other than that everything is fantastic.--[[User:Z3305561|Navneet Ahuja]] 12:48, 21 September 2010 (UTC)

Group 3: amniocentesis
I found this project very interesting and it was very well written, by far it had a more scientific feel than the others. All of the images and tables were relevant and informative. I felt that I learnt plenty about the particular diseases that the diagnostic technique could find as there was plenty of detail on this.

What could be improved?
Probably some more pictures from sources other than Wikipedia.

--[[User:Z3254433|z3254433]] 07:17, 20 September 2010 (UTC)

Hi Guys, This project is very well written, and also easy to follow. i really, really, (really!) liked the disorders section, with the table, graph and pictures it made it really easy to follow, and interesting! when you see a picture like the anencephaly one, it makes you stop and read what its about! I also like how many student drawn diagrams there are, you have really put in a lot of effort. I definitely learnt a lot from reading this page, Thanks!

What could be improved: The ethics section has no references, also the current research section seems to be copied straight from the internet, be careful with this, while it is referenced in one part, it is still plagiarism to copy and paste, you need to re write in your own words and reference. there are also a few spelling mistakes in the ethics section - waranted=warranted, phsychological=psychological

--[[User:Z3265772|z3265772]] 23:41, 20 September 2010 (UTC)

--Group 3 Amniocentesis

This group has shown a vast knowledge of the topic and has more than enough information from a number of sources. The diagrams that were hand drawn were very effective and clear to help the reader gain an understanding of the topic. On what can be improved: The size of the headings could be a little bigger to be more clear, also the same with the pictures, use them to break up the paragraphs which will make the page easier to read and take in the information. Thanks guys you did great.

--[[User:Z3290040|3290040]] 10:19, 22 September 2010 (UTC)

This project was very well written and highlighted the main points of amniocentesis. The structure of it was very clear which made it easy to understand and follow. I feel that it was a good project addressing students and people who don't know much about this area.

What could be improved is that there were no references in the ethics section which may be a problem. Also a glossary may be needed at the end of the page.

--[[User:Z3291079|z3291079]] 03:04, 21 September 2010 (UTC)

This project is very informative and did a good job in stating what the test is about and explainning how it is carried out. I really like the uses of sub-headings making it very easy to follow. However I feel that there are too little information in the accuracy of the diagnosis although the percentage is quite high, using only one study to support the accuracy does not seem to be convincing enough.

What I think could be improve would be looking up a meta-study which compares the studies done on amniocentesis to provide more information about its accuracy and how reliable it is with respect to the various disorders which it can detect.

--[[User:Z3216889|3216889]] 12:27, 22 September 2010 (UTC)

I personally found the introduction to resemble that of an essay; I don't think an outline of what the webpage consists of is completely necessary seeing as there is a table of contents. A Glossary and proof reading are also needed. Other than that Your web page is great. The table of disorders that you have included is encompassing and simple enough to easily follow. It s a very well-rounded overview of Amniocentesis and I congratulate you on a job well done!--[[User:Z3252083|z3252083]] 12:30, 22 September 2010 (UTC)

Page layout was nicely organised! It had logical flow and was simple to understand. History was covered well, and prodedure was explained very thoroughly and was quite scientific yet simple about the information on what happens in the lab, ie. karotyping. The student drawn images were drawn really well and shows good amount of effort that has been put into them and it supplemented the text really well. The pie chart and the picture I found was very eyecatching and made me more interested to read about the topic. Ways to improve is to expand on the current research and add a glossary at the end. Overall good job!
--[[User:Z3224500|z3224500]] 12:51, 22 September 2010 (UTC)

----

{{Template:Projects10MHtal

--[[User:Z3292208|z3292208]] 01:55, 16 September 2010 (UTC)

Actually guys you know what I just realised. '''VERY IMPORTANT''' PLEASE READ THIS:
Mark (Hill) told us that peer assessment was due today and we're not allowed to edit the page until the peer assessment is over which is next thursdays lab. Meaning we only have from next thursdays lab, '''23rd''', to the following monday, the '''27th''' to finish the page.

This is why we were supposed to have our projects pretty much finished for today and only adjust it slightly in response to the peer assessments. So '''312''' you'll have '''4 days''' after next thursday to finish your sections and allow us to look at it to give you feedback in case it needs to be further edited before the FINAL assessment.

This is going to be a very tight squeeze since you havent done anything before this morning. That is why i may have seemed harsh in my response because we have very limited time and it isnt fair to us to have contributed so late to the due date.

Tegan.

--[[User:Z3292208|z3292208]] 01:45, 16 September 2010 (UTC)

Yes the previous years had more than 400 edits, this project is due in a week and a half (11 days!) and compare the amount of edits me and mark have done to how many you have done. I hope this will be enough time for you to finish your sections and allow us to have a look at it in advance to the due date and give you feedback as its a group project and we are supposed to help each other. Me and mark and have given each other feedback on our sections and helped each other to make it better, I think that is what makes a successful group project - working together.

If you think the rest of the project is too simplistic tell me where my parts can be changed and ill look into it. The introduction is meant to outline the assignment and I think that's what i did. The procedure section clearly outlines every step of the procedure, I even went into the detail of the analysis of the amniotic fluid in the lab (including a diagram i drew) which I was worried was too technical for people without knowledge of the topic to understand but Mark assured me it was good and clear. I asked everybody for their opinions last week, Mark replied and told me he found it easy to understand but it had enough detail. Read it and tell me what you think.

Ethical issues, no matter how complicated it is, can still be written in a clear and concise format, with clear issues that are introduced then elaborated on with references to back up the argument. Sub headings can be used I think that would break up a big section of text well, thats what I used in my sections.

Are the drawings okay? It was the best I could do, I think I showed the procedure clearly and it complements the relevant sections. Do you have any ideas about pictures for the other sections? Are you going to include any pictures in yours?

Tegan.

--[[User:Z3129413]] 00:47, 16 September 2010 (UTC) Thankyou 3292208 duly noted. Categories will be edited and valid criticism and typos will be corrected. I found your introduction and subsequent sections lacked some scientific feel, in fact the whole page overall is rather too simplistic in my opinion. This of course can be edited as can the work I have done. Outlining Ethical issues as Im sure you are aware is rather more complicated than merely introducing the subject and listing how the proceedure is conducted, and that I have been trying to find the best way in which to present this, however I thankyou for suggesting the way in which it could be done, this will have to be considered when I edit my work. I did see that previous pages have had upwards of 400+ edits BEFORE the FINAL submission. I hope we can all edit our work to make it better which of course will be done way before the due date.

--[[User:Z3292208|z3292208]] 19:33, 15 September 2010 (UTC)

as much as im grateful you're finally putting something on the page doing it this late, a few hours before its due, doesnt give us any time to give you feedback for it.

Since im awake though for Diagnostic Accuracy one study isnt enough to give a final say about the topic, you still have to make an overall judgement of the accuracy of the procedure or even show that its become more reliable through trends over time.

Ethical issues needs to be structured in a more clear and concise format, its too much writing in one block and isnt clear to the point. Its hard to tell what your key points of argument are. I also dont think using questions to the audience is a good idea, you should more so just be presenting the issues to be thought about but using hard evidence to present them instead of using rhetorical questions to just put the ideas out there. You should also mention one of the KEY ethical issues about amnniocentesis = ABORTION. Theres also no references in that section.

In current research that paragraph reads exactly like in the article you referenced, we have to write it in our own words or its plagiarism. And whilst copying it you made a mistake the article says the stem cells do NOT form tumors in vivo (whatever that means which should be explained on the project page) and you wrote that they do form tumors.

I hope you'll at least edit it more than a few hours before the final assessment is due.

See you in the lab.

--[[User:Z3254753|Mark Woods]] 11:14, 15 September 2010 (UTC)

yea soz lack of references is my bad, i havnt dont it this week coz i kinda got a mid session on friday ive bin concentrating on.

c u tomo =)

--[[User:Z3292208|z3292208]] 11:09, 15 September 2010 (UTC)

Yeah i think its looking good, slight lack of references but we can fix that after i guess. and we should prob polish it up a bit and make sure it reads heaps smoothly but we can do that after i guess. hmmm missing sections does not look good tho! looking forward to seeing everyone at the lab tomorrow. see u then

--[[User:Z3254753|z3254753]] 10:31, 15 September 2010 (UTC)

ok last nite before peer review, do we need anythin else to do? i think it looks very gud for peer review, besides the missing sections:S we can change and add after peer review of course

--[[User:Z3254753|z3254753]] 13:23, 14 September 2010 (UTC)

yea. dont worry, mayb its just my computer lol

--[[User:Z3292208|z3292208]] 10:55, 14 September 2010 (UTC)

The actual heading "Risks"? It looks normal on my page...

--[[User:Z3254753|z3254753]] 09:26, 14 September 2010 (UTC)

nah its better like that :)

another lil detail i tried to fix was that the "risks" heading is pushed over from the picture. how do we fix that?

--[[User:Z3292208|z3292208]] 06:07, 13 September 2010 (UTC)

Hey also hope you dont mind i made ur pie pic a little bigger cos i thought it would look good like that but feel free to change it back if you want!

--[[User:Z3292208|z3292208]] 03:38, 13 September 2010 (UTC)

Oh sorry lol i forgot to tell u, he mentioned it in the last lab

Hey also that pie diagram you put in maybe make it as a thumbnail and add a caption to the bottom of it saying what it is?

Cant believe out of all the disorders mentioned you had to put that picture up!

--[[User:Z3254753|z3254753]] 00:19, 13 September 2010 (UTC)

omg y ddnt u tell me! i thought we had to hav it done for peer assement today :S. thats much better though =)

--[[User:Z3292208|z3292208]] 22:13, 12 September 2010 (UTC)

Hey mark your section is looking good.

I really dont think we should put those other sections up they dont read well at all.

Also mark said to us in the last lab that you missed that the beginning of this thursdays lab is the last time we're allowed to edit our pages and from then the peer assessments start and we have until the following lab to assess everyone elses group project so we have until then, hopefully before then we'll get a reply back from mark or . And also other groups have missing sections so they must have people missing too

--[[User:Z3254753|z3254753]] 13:52, 12 September 2010 (UTC)

so this is what i have, i think its gud enough for peer assessment. I plan to add more to disorders, both chromosomal n neural tube defects are gonna get more info on the main ones. I also want to expand on my table with more disorders and student made drawing of tree diagram catagorizing chromosomal defects.

Tegan, do you think this is enough for tomorrow?

And im ripping straight from the discussion page just to have something other the other headlines, it will b more embarrassing to have blank sections, so i figured well throw in wat he was planning to write

--[[User:Z3254753|z3254753]] 11:01, 12 September 2010 (UTC)

yes they can be, such as Klinefelter's syndrome, i think thats wat i sed isnt it?

he got bak to my first email from like wednesday last week n sent an email, i hav since sent a couple of msgs which hasnt resulted in anything, i dont know wat to do!

--[[User:Z3292208|z3292208]] 10:25, 12 September 2010 (UTC)

Hey i read the chromosomal disorders bit you added about translocations etc, cant disorders also be genetic like sex linked diseases carried on the X chromosome?

Has mark gotten back to you at all? He's away this week too which is a bugger...

And yes a very nice moustache lol

--[[User:Z3254753|z3254753]] 04:46, 12 September 2010 (UTC)

dr murray barr had a glorious moustache lol

--[[User:Z3254753|z3254753]] 03:00, 12 September 2010 (UTC)

haha yea it makes things a little easier :) just check out wen looking wat kind of licensing it has

--[[User:Z3292208|z3292208]] 02:46, 12 September 2010 (UTC)

Oh geez why couldnt you warn me before! yeah thats heaps good, so much easier.

--[[User:Z3254753|Mark Woods]] 02:44, 12 September 2010 (UTC)

Check out the copyright details

http://en.wikipedia.org/wiki/File:Enencephaly.jpg

yes i guess its not straying from the topic.

--[[User:Z3292208|z3292208]] 02:27, 12 September 2010 (UTC)

I dont think thats straying too far at all cos those are the exact things amniocentesis prevents so it just shows how useful the procedure is!

actually pics of what goes wrong during amniocentesis would be good too (i.e in risks).

how can you use that photo? cos its from wikipedia? hmmm.... giving me some ideas lol

--[[User:Z3254753|Mark Woods]] 02:10, 12 September 2010 (UTC)

It freaked me out too! We can actually use that image on our page if we want lol thanks for the picture ideas.

I will be expanding on the disorders section, and its a good idea to include photos of ppl wit the ssyndromes look like. Im only concerned about straying to far from the amniocentesis topic?

--[[User:Z3292208|z3292208]] 01:56, 12 September 2010 (UTC)

Omg mark i was just looking at the links you put in your disorder table (thats really cool by the way) and i looked at the Anencephaly one, did you see the pic on that page??? freaked me out lol

hey but also are you gonna put more detail under that section too?

--[[User:Z3292208|z3292208]] 01:50, 12 September 2010 (UTC)

Hey mark,

Oh forgot to mention that article just lists those complications it doesnt actually go into any detail about them.

Uum not sure what to do about the missing sections, I could email 312 using his student email, is everyones just their student number then @unsw.edu.au?

Yeah speaking of pictures i found it really hard getting permission for pictures, thats why i drew a couple but i still want to try find one of the scientists. Yours i think would be better getting pics of people affected by the disorders you talk about? what do you think? Or you could find one maybe of the neural tube and showing the top and bottom which is closes in normal development. just some ideas.

--[[User:Z3254753|z3254753]] 01:36, 12 September 2010 (UTC)

thanks tegan, il do that today
also, wat r we gonna do about the missing sections? :S

i emailed dr mark bout it but he hasnt gotten bak to me

also, any ideas forstudent drawn pics i could hav in my sections?

--[[User:Z3292208|z3292208]] 11:07, 11 September 2010 (UTC)

Hey Mark

I just read in an article i was reading they make a comment about risks and they list a few but highlight that there are risks for the fetus and risks for the mother:

# Fetal complications = deaths from abruptio placentae,infection, fetal haemorrhage, and puncture of the fetus.
# Maternal complications = maternal haemorrbage, peritonitis, rhesus isoimmunization, and premature labour.

http://www.ncbi.nlm.nih.gov/pubmed/4255487

If you wanna have a look and maybe add to your section?

--[[User:Z3292208|z3292208]] 02:44, 11 September 2010 (UTC)

Yeah more detailed paragraphs sounds good, but as a summary the table is spot on.

--[[User:Z3254753|Mark Woods]] 02:41, 11 September 2010 (UTC)

yea i no wat u mean, ive confused myself a bit with wat is actually relevant to put in. I was gonna hav an intro, but how bout also paragraphs explaining the main ones? thats better place to puts pics of the chromosomal disorders n stuff.

--[[User:Z3292208|z3292208]] 22:21, 10 September 2010 (UTC)

hey mark,

table looks good, i thought it might be more detailed but i guess that covers everything. you should put some more references in though, im still working on mine, and also you referenced a website i used a couple times, on the how to reference page there's a way to put multiple references in the page from one link so check that out.

also some pics would be cool for the disorders if you could find them? im gonna try find some pics for my history section, im in the process of getting permission to use a picture of cells with a Barr body, the part that shows the sex of the fetus, which Murray Barr discovered.

Oh and yeah maybe put a column in for Type thatd be good.

Anyways our page isnt looking as good as last years! i guess its missing a third of it though...

--[[User:Z3254753|z3254753]] 03:56, 10 September 2010 (UTC)

guys im working on the table, im not sure bout the columns, maybe i shud have Disorder, Type(chromosomal), Cause, Diagnostic rate using amniocentesis?

suggestions?

also tegan, maybe a headshot of a couple of the scientists? ur section looks finished, so that idea is only if ur at home bored :P

--[[User:Z3254753|z3254753]] 02:16, 10 September 2010 (UTC)

u guys shud check out all the intructions just to make a table haha

--[[User:Z3254753|z3254753]] 00:36, 9 September 2010 (UTC)

aight il hav most of disorders done tonight, but il put it on the project page tomo

thats kinda what ive bin doin, i gave a lil intro to it before the table.

--[[User:Z3292208|z3292208]] 22:38, 8 September 2010 (UTC)

Hey mark yeh a table is a good idea how about having quite a simplified table first just showing the different chromosomal and neural tube defect just as a little summary then after it have headings and go into all the detail? you could also add a picture column in the table for each disorder? or put that with the bulk of info either way i guess. sounds good tho!

Hey 312 how are you going with your section? Im getting worried not seeing a draft or anything of yours since its due monday! Let us know how you're going please!

Tegan.

--[[User:Z3254753|z3254753]] 06:16, 8 September 2010 (UTC)

hey guys,

with disorders, I was thinking bout doing a table. ive got an intro n separate the disorders into chromosomal abnormalities and neural tube defects to talk bout in paragraph form, but i was thinking of a table to show the different disorders. what do you think?
Or do u think i shud stil go through the main ones individually n then hav the table?

also, a table wud break up all the paragraphs :P

--[[User:Z3254753|z3254753]] 08:42, 7 September 2010 (UTC)
yea, its stil not working, cud b somethin wit my computer not sure. its just not letting me edit the project page, im tryin to put the refernces in to risks.

which is also weird coz im having no trouble rditing this discussion page.

--[[User:Z3292208|z3292208]] 07:20, 7 September 2010 (UTC)

Are you testing the page mark? lol. still having troubles with the site?

--[[User:Z3254753|z3254753]] 07:08, 7 September 2010 (UTC)

hey, the added section is great. I was gonna go through wat is being looked for for each of the disorders i look at (e.g the presence of an extra 21st chromosome). for some reason its not letting me change my risk section, so ill keep going with my other section n come back to it and itll hopefully work.

--[[User:Z3292208|z3292208]] 07:00, 7 September 2010 (UTC)

Just putting this here for myself:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2035329/

--[[User:Z3254753|z3254753]] 07:03, 7 September 2010 (UTC)

haha just read through it, yea the sentence cuts out, thatnks for proof reading. ill check out ur section soon, my computer has decided it doesnt want to open our project page

--[[User:Z3292208|z3292208]] 06:46, 7 September 2010 (UTC)

Hey also i added more detail to the end of my procedure section just about how they treat the sample once it gets to the lab and chromosome mapping etc, do you wanna read it and tell me if it makes sense to you and isnt too much science lingo or hard to understand at all?

Thanksss

--[[User:Z3292208|z3292208]] 06:44, 7 September 2010 (UTC)

Yeah that sounds good you can still have a section on miscarriages and just mention that it is the common result of all the other complications. Just to make it a bit clearer for people who dont know anything about it.

But yeh it looks good otherwise! yeah that one line i was just like what that doesnt make sense lol

Oh and i just mean that sentence about the mothers immune response did you forget something on the end of it or something? I just dont understand it is all

--[[User:Z3254753|z3254753]] 06:40, 7 September 2010 (UTC)

whoops that was from the draft lol i confused myself reading the study.

and i kinda rushed my section on the rhesus factor, i just went off wat ive learnt before. il go back over and make it more clear.

I wasnt sure whether to make miscarrages its own section because its connected to all the risks, its like the ultimate bad result for all the risks, thats why i thought it should go in the intro.

I will fix up the intro, seperating into actual introduction and miscarriages, wat do u think?

--[[User:Z3292208|z3292208]] 06:30, 7 September 2010 (UTC)

Hey also what did you mean in the top bit where you said "This cannot be attributed to the procedure of amniocentesis."?

--[[User:Z3292208|z3292208]] 06:28, 7 September 2010 (UTC)

Hey I had a look, looking good. That first section though it sort of was a bit confusing when i first read it, maybe put an intro to risks and then a subheading just about miscarriages and what causes them (uterus contracting etc) and put those stats in there? The physiological risks is really good, its really clear and easy to read.

This sentence doesnt really make sense when i read it:

"A transfer of blood would stimulate an immune response by the mother against the different blood type, the result being that the mother’s own immune system."

But yeah other than that its good!

Tegan.

--[[User:Z3254753|Mark Woods]] 06:17, 7 September 2010 (UTC)

just uploaded risks. definitely needs pictures or something to break up the text.

wat do u guys think?

--[[User:Z3292208|z3292208]] 04:02, 7 September 2010 (UTC)

Yeh i dont mind slipping it into mine unless you can elaborate on it and it fits well in yours? Maybe we can decide once both sections are up and have a look. But in that article in the results section its got some good statistics for you about still births and miscarriages.

--[[User:Z3254753|z3254753]] 03:55, 7 September 2010 (UTC)

thanks for the reference help :)

and i think it does fit better under eligibility, it works under my section as well because its about reducing unnecessary risk, but in this case we should keep it all together.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2464303/

look through this and see whether it fits in your section, no rush.

--[[User:Z3292208|z3292208]] 03:42, 7 September 2010 (UTC)

Dammit i dont know how to put the reference in without it making an actual reference lol but have a look in the edit version!

--[[User:Z3292208|z3292208]] 03:40, 7 September 2010 (UTC)

Okay so here is what you put in the page where you want the reference <ref><pubmed>XXXXX</pubmed></ref> but you put the pubmed article number in the middle and when you save it all the details appear at the bottom reference section on the page.

That abstract is good, i guess from that we can say something like "As observed in a study carried out in the period 02-05 it can be seen that an increased risk of Down syndrome is a major reason that most women choose to take the amniocentesis test, compared to suspicious ultrasound findings which was not listed as the basis for many womens choices. And then reference that article.

But about that, where it says "increased risk of Down syndrome" do they mean increased risk due to the mother being over 35? If you reckon thats what they mean we should probably write that instead, like write the cause of the increased risk you know.

But yeh not sure did you want to add this into your risk section? Do you think it fits? I can put it in my section where i covered whose eligible for the procedure and you can focus more on the risks and the things that could go wrong like miscarriage and all that. What do you think?

--[[User:Z3254753|Mark Woods]] 03:26, 7 September 2010 (UTC)

this is an abstact:

This is a retrospective review of case notes of all pregnant women undergone amniocentesis in our department during the period 2002-2005. Two main operators performed the procedure, using 22 gauze needle usually and 20 gauze should longer needle was needed. Sevendy three patients undergone amniocentesis. The reasons for having this procedure were: increased risk for Down syndrome in 68% (50/73), maternal request in 24% (18/73), suspicious ultrasound findings in 4% (3/73) and family history in 3% (2/73). Maternal age ranged from 20 to 45 years and the gestation time that amniocentesis was performed was 15 to 23 weeks. Fluorescence in situ hybridization (FISH) and culture were used in order to obtain karyotype results

--[[User:Z3292208|z3292208]] 03:40, 7 September 2010 (UTC)

What do you mean, percentage of mothers having children over 35 and women with histories of genetic disorders and all that? Like statistics from a specific study?

For pubmed references go to the page in edit version and have a look at what i put for it, you copy and paste that and just put in the pubmed number for the article you used where the number is in the middle. The other references you have to write it out but have a look at the how to reference on the site down the left hand side.

--[[User:Z3254753|z3254753]] 03:19, 7 September 2010 (UTC)

ur rite about repeating urself. I found some research where they give percentages of occurence of each reason. I guess this allows me to be slightly more specific or technical which is should be expected from my section. what do you think.

how did u do the references?

--[[User:Z3292208|z3292208]] 03:50, 7 September 2010 (UTC)

Hey Mark thats looking really good! The emotional state of the mother part is heaps good i didnt realise you could find out specific hormones but thats really interesting. That beginning bit though about the guidelines present to assess whether a mother is in a top priority for the procedure I covered in my section so maybe we shouldnt repeat ourselves or it will sound a bit repetitive? I guess you could just mention there are certain women more suited to the procedure due to the number of risks but maybe focus more on what causes the miscarriage if it occurs?

Also we can put more than one student drawing but i think we need at least one. We do need more pictures in it though.

Hey 312, how are you going with your section?

Tegan.

--[[User:Z3254753|z3254753]] 14:25, 6 September 2010 (UTC)

general outline for risks.

Risks
There are risks involved in the procedure of amniocentesis. There is a chance, however small, of a miscarriage As stated before, only certain people should undergo the procedure because of these reasons. This involves:
• Maternal age is considered, women older than 35 are at a higher risk of having children with chromosomal disorders.[2]
• History of chromosomal disorders in the family, testing if the parents are Rh positive or Rh negative.[3]
• History of previous children born with a genetic defect.
These guidelines allow for properly measuring the risk of the procedure against knowledge that can be gained from it. A doctor or genetic counsellor should be consulted prior to the test.

Timing

Amniocentesis should be performed at a time when enough amount amniotic fluid can be taken for diagnosis without affecting the course of the pregnancy. Generally, this is around weeks 15 -19. As indicated under the procedure section.

Infection

There is a risk of infection with amniocentesis. It is intrusive as it requires contact to be made with the amniotic fluid by a needle through the skin, abnormal wall and uterine wall. The transfer of bacteria can occur if the needle and area of needle insertion into the lower abdomen of the woman are not properly sterile.
This risk is lowered by all persons involved in the procedure properly washing their hands and working in a sterile environment. Swabbing the area where the needle is inserted is the most common method of keeping these areas clean.
This also leads to the possibility of transfer of blood plasma from the foetus to the mother. This can cause major issues in the instance where the rhesus (Rh) factor of the baby is positive and the mother is negative. A transfer of blood would stimulate an immune response by the against the different blood type, the result being that the mother’s own immune system.

Foetal contact

The chance of the needle hitting the developing foetus is a risk factor. This can be avoided by constantly using ultrasound o see the position of the developing foetus.
Psychological Risks

The emotional state of the mother can have affects on the outcome of the pregnancy. Learning if the baby has conditions can lead to an emotional state such as depression and anxiety. These are the effects of results that amniocentesis gives these social issues. These can elevate levels of certain hormones which imbalances the pregnancy such as citrol, influencing concentration levels of others in the blood, activating receptors, release of adrenaline, effects on blood pressure and nutrient supply to the baby.

tegan, i stole one of ur paragraphs, just coz it fit so well. il change it wen i put it on the assignment page. il better explain the hormonal changes due to stressed, thats fine. Ill put this up on the page, along with its references n then disorders by thursday night.

Risks are covered pretty well in ur procedure section Tegan, so i refer to it a few times :P

--[[User:Z3254753|z3254753]] 23:38, 5 September 2010 (UTC)

hey the drawing is really good!

Did we only need one student drawing?

--[[User:Z3292208|z3292208]] 03:51, 7 September 2010 (UTC)

Hey yeh it was good, altho only half the class turned up.. The week after the break we have a new lecturer whose taking the lectures and lab too. Let me know if u think the drawing I did is ok :)

--[[User:Z3254753|z3254753]] 06:35, 3 September 2010 (UTC)

how was the lab yesterday guys? soz i missed it

--[[User:Z3292208|z3292208]] 00:43, 2 September 2010 (UTC)

history links:

* http://www.ncbi.nlm.nih.gov/pubmed/13114925 - '''The Pattern of Haemolytic Disease of the Newborn
'''
* http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1799312/

* http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1050098/pdf/jmedgene00080-0015.pdf

* http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1806475/pdf/bullnyacadmed00267-0043.pdf

procedure links:

* http://www.nature.com/scitable/topicpage/karyotyping-for-chromosomal-abnormalities-298

* http://www.nlm.nih.gov/medlineplus/ency/article/003935.htm

--[[User:Z3254753|z3254753]] 22:48, 1 September 2010 (UTC)

N yea uploading mine in the mid sem break =)

--[[User:Z3292208|z3292208]] 09:28, 31 August 2010 (UTC)
Hey Mark the breakdown for risks and disorders looks like a good structure, looks like you'll cover everything.

--[[User:Z3129413|Z3129413]] 01:05, 31 August 2010 (UTC)z3129413
will be working on page all day wed and will be online here.

--[[User:S8600021|Mark Hill]] 00:46, 31 August 2010 (UTC) You have the major headings and some content added to some sections (but not all) on your project page. I cannot see any additional resources, images that you have sourced from other scientific sources, nor the student drawn figure. You need to have this updated before this weeks lab when I will be reviewing all projects.

--[[User:Z3254753|z3254753]] 00:51, 30 August 2010 (UTC)

so this is how I've divided up my sections further

risks:
for each risk;

what is it? Why is this a risk (eg infection, hitting the fetus)

how is this risk reduced?

At which stage is performing amniocentesis most risky.

Stats of how often problems have arise in pregnancy connected to amniocentesis

Disorders:
I can't just write a whole thing on each, as much as I'd like to, it'll b like having a whole section on disorders, not amniocentesis.
So For each of the main disorders:

intro-discription, rates in birth

what stage of pregnancy can this be detected?

how it is tested for / detected

what do they look for? Eg variation chromosomes

why do they look for this? This mite belong in ethics but by this title I mean why do they test for this genetic disorder.. Is there some level of seriousness in a family history that warrants this test.. They test for each thing individually once they hav the amniotic fluid sample.

Suggestions?

--[[User:Z3292208|z3292208]] 05:59, 29 August 2010 (UTC)
Hey guys just wanted to remind you this is due 2 weeks tomorrow ok!

--[[User:Z3292208|z3292208]] 03:57, 26 August 2010 (UTC)

Hey Mark I put on the page a picture of trisomy 21, Down sydrome, to slot in the disorders section.

--[[User:Z3292208|z3292208]] 11:10, 25 August 2010 (UTC)

Picture of the procedure:

http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=mga&part=A1760&rendertype=figure&id=A1761

http://adam.about.com/encyclopedia/Amniocentesis_1.htm

Picture to put in from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2532964/

--[[User:Z3129413]] 08:15, 25 August 2010 (UTC)

Thanks 325.

--[[User:Z3254753|z3254753]] 07:45, 25 August 2010 (UTC)

yea bro, il bring my camera tomo.

--[[Z3129413]] 06:06, 25 August 2010 (UTC)z3129413
The page layout is awesome... Anyone have a digi camera at the moment can you bring it thurs/fri.. can get some snapshots for the page... return camera next lab if feasible...

--[[User:S8600021|Mark Hill]] 04:39, 23 August 2010 (UTC) Ok you guys have been doing some talk here. Now is the time to start thinking how to populate your project page subheadings. Remember that anything you do can always be undone or altered at a later date. I also see an absence here of good visual material for your project.

--[[User:Z3292208|z3292208]] 02:01, 19 August 2010 (UTC)

'''History'''

Key scientists:

*'''Douglas Bevis'''
** His study of mixing Rh +ve and -ve blood and of hemolytic disease was a key event in making the technique well known.
** Hemolytic disease in newborns occurs when the mothers antibodies attack the fetal red blood cells, the antibodies cross the placenta to the fetus as the mother helps to strengthen the growing fetus's immune system, in which doing so may do the opposite.
** http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=rbcantigen&part=ch4
** http://www.discoveriesinmedicine.com/A-An/Amniocentesis.html
*'''Murray Barr''' and '''Ewart Bartram'''
** In the 50's the use of amniocentesis was used to find out the sex of the baby, not originally to diagnose chromosomal or neural tube defects.
** 1949 were the first to study if the sex of a fetus can be found using amniocentesis anaylsis, and with that the possibility of sex linked diseases like hemophilia (a disorder of blood clotting).
** The way the sex could be found = female cells have a cellular body attached, called the Barr body or sex chromatin, and male cells don't. This extra body, the sex chromatin, can be seen under the microscope.
** Until amniocentesis in the 1950's, the only diagnostic technique used to warn women of having a child with a sex linked disease would be statistics based on family history, which was nothing more than loose probability.
** Therefore is the sex of the baby could be found out pre-birth (along with the genomes of the mother and father of certain disorders), more reliable statistics could be calculated as to whether their baby might have a sex linked disorder.
** http://www.ohiostatepress.org/books/Complete%20PDFs/Rothenberg%20Women/05.pdf
* '''Fuchs and Riis'''
** 1956 they were the first to successfully determine the sex of a baby using amniocentesis by the presence of a Barr body.
* '''Steel and Breg'''
** 1966 noted that amniotic fluid cells were able to be karyotyped, chromosomes can be analysed.
*'''Dr. Carlo Valenti''' = 1968 first to use amniocentesis to diagnose a chromosomal/inherited disorder.
* 1980's ultrasound techniques took out the guess work to guiding the needle during the procedure.

'''Procedure'''

''Who is eligible for the test?''
* Since the procedure is invasive and therefore not without a number of risks, numerous tests are taken before to decide whether the mother is in the top category of women with a high chance of having a child with chromosomal or neural tube defect disorders.
*These pre tests include:
** Checking for abnormal ultrasound features
** Maternal age is considered (>35 high risk of chromosomal disorders)
** History of chromosomal disorders in the family, Rh +ve/-ve of the parents.
** History of previous children born with a genetic defect.

''When can the test be taken?''
* Most commonly during 15-16 weeks of gestation (during the second trimester), but can be done between weeks 14-20.
* Second trimester amniocentesis is between weeks 15-18 (commonly wk 15-16).
* Early amniocentesis is in the first trimester between weeks 11-14.
** Has shown to have a rate of 3 times the rate of miscarriage.
** Early amniocentesis has been conducted since the delay in the tissue analysis of an average of 2 weeks means if abortion is the option taken it is physically harder for the mother at a later stage of pregnancy, and emotionally as well.
** The more common time is during second trimester since there is less risk of miscarriage and complications, and if an early diagnostic test is requested, CVS is a more recommended option.
* Tissue culture takes a further 2-3 weeks before a result can be found.

''Steps of the procedure''
* Counseling for the mother = review of genetic family history and history of any birth defects in previous children of the mother. Mother is also informed of the risks associated with the procedure, and is able to make a decision to continue based on weighing up the risks with her personal calculated chance of having a fetal abnormality.
* Area is cleaned before needle insertion with an iodine solution.
* Local anesthetic may be used but since there is little pain it usually isn't used to avoid having a second needle insertion.
* Needle inserted and 15ml fluid taken, takes approx 30 seconds to withdraw the fluid.
* Before the needle is inserted and whilst the needle is inside the uterus ultrasound is used to avoid harm to the baby and placenta.
* After fluid is taken the baby's heart beat is checked to ensure there was no harm.
* Fluid is cultured, the chromosomes are mapped = called karyotyping.
* http://www.nevdgp.org.au/info/melb_us/Amniocentesis_melb.htm
* http://www.plus-size-pregnancy.org/Prenatal%20Testing/prenataltest-amnios.htm
* Amniotc fluid taken out is centrifuged at 4000 rpm for 15 minutes and then filtered. The filtrates are then scanned in a recording spectrophotometer.

'''Note:'''
* For '''diagnostic accuracy''', comparing this technique to other techniques, I read that Chorionic Villi Sampling (CVS) can be used earlier on in the pregnancy, but the disadvantage of that is there is a greater risk of miscarriage. So there is a pro and con for amniocentesis against CVS.
** Also i just thought to include in '''diagnostic accuracy''', what about the occurrence of false positive results?? Are there any statistics relating to false positive cases, if there have been cases what were the outcomes, has there been any incidence of abortion as a result of a false positive for a disorder? (That could be an '''ethical issue''' too, are women more wary of the procedure in case it isnt 100% reliable and there is a chance of false positives?).
** Have a look at this site too for '''diagnostic accuracy''', there's a whole section which looks really useful, it says that even if the results of the test are 'normal' doesn't guarantee a normal baby, it also explains how some chromosomal tests can be ambiguous and an unsure diagnosis can result leaving mothers with uncertainty. http://www.plus-size-pregnancy.org/Prenatal%20Testing/prenataltest-amnios.htm
* For '''risks''', Evidence supporting the 1% risk of miscarriage statistic in the article http://www.ncbi.nlm.nih.gov/pubmed/18923654
** Another '''risk''', could the stress and anxiety for the mother before the procedure be harmful to the baby? Added stress and anxiety in the chance of an abnormal result and possible abortion? Seems like a small point but I found an article about it so thought I'd let you have a look. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2859418/
** Mark also have a look at this site, it has a whole detailed section on '''risks''' which looks really good: http://www.plus-size-pregnancy.org/Prenatal%20Testing/prenataltest-amnios.htm

--[[User:Z3254753|z3254753]] 23:17, 18 August 2010 (UTC)

Another point on ethical issues is the ethical decisions to be made if a problem is found. Is it ethical to terminate a pregnancy if it is found the child will have mental retardation? What factors are involved when making these choices? I don't think there is a right answer for everybody, so maybe its important in this section to present ethical arguements for all sides.

So yea, I think you've covered all the ethical issues, nice work!

Mark

--[[User:Z3292208|z3292208]] 23:06, 18 August 2010 (UTC)

For ethical issues i was thinking more along the lines of is the test too invasive for the mother? Not necessarily the risks (thats being covered separately) but would many women be unsure about the procedure because it is invasive and possibly painful, do people believe there are other techniques that could be as effective and more attractive to women. In this we could also do a brief comparison between amniocentesis and other diagnostic techniques, the positives and negatives of the procedure against others.

Also another ethical issue would be the choices the mother would make if a positive test of a disorder was found.

Tegan.

22:54 August 18
Z3129413: Yes tasks outlines are good. Diagnostic accuracy according to NATA guidelines can be accessed quite easily. NATA is the testing accrediting agency in Australia, which monitors pathology labortory testing accuracy in accordance to intesively reviewed set guidlines. Any lab operating wants to have NATA accreditation in order to display the logo on request forms etc. I think that all hospitals outsource genetic and pathology testing to semi or fully private companies which can also be part of the government health service. Those labs that are aligned with hospitals, usualy those located on the hospital campus itself, are all absolutely operating in accordance with NATA guidlines. The further question here is what are the inherant diagnostic inaccuracies associated with amniocentesis itself, if any? I dont know at this stage. Another question is , can amniocentesis be conducted in private rooms by a clinic, GP or other? Therefore are patients attending here protected by some sort of accreditation monitoring agency?
I think leaving the diagnostic accuracy to involve only Australia is relavant, as it can be safe to assume that in places where medical proceedures are commonly understood to not generally fall below a certain standard, what happens in Australia applies to them also as the medical information and research is shared between these locations via published research studies from various universities etc. and are used by the various national accrediting agencies as reference material in formatting the guidlines.
I will look into accessing the current plus or minus degrees of error and reference ranges used to diagnose the top most test requested for.

In tackling the last two topics,

A).
Ethical issues and current research perhaps can tie in together (an option)
- as at a glance I do not think there is much controversy surrounding the test per se,
other than in terms of potential physical trauma to mother or infant due to accident at time of proceedure or malpractice, possibly instrument sterility issues re bacteria introduced into womb or abdominal wall. In light of the risks associated ( therefore proceedural ethics) in this regards,I will have to weigh it up with investigating if there are simple blood tests that can accurately diagnose the same tests requested from an amniocentesis. But this will be covered by 3. RISKS.

Alternate proceedures for the tests could be covered by 'Diagnostic accuracy' I will have to look into this. Maybe other proceedures (blood tests) are more accurate for some tests.
so lets call that safety/ accuracy concerns. Maybe not to bring ethics into this at this point.

Propose '5.Diagnostic accuracy and efficiency'.

Propose '6.Outcomes from results'
Of course there is the issue of receiving a positive test result. I can cover this as the 'medical outcomes' of the tests (what it allows the parents to do in light of the knowledge). Here is a major source of ethical debate.

Propose '7.Current research trends and ethical debates'
State main streams of current research and the place they are being conducted, in order to highlight the fact that there may be differing laws govering research restrictions.
give a brief outline of current laws (probably sourced from UN. I will aim to give specific examples of where public oppinion has opposed proposed research ideas. If it appears that personal related morality versus 'yes it is proceedurally ethical(safe to mother etc)' I will state that opinions differ in this regard. I will outline the purposes of the research and by then aiming to show any alternate methods of approaching the same research, if any, the ethical debate can then be structured in this way.
For now I think this is the best way to approach this.

ie, research says yes switch to uranium to alleviate the use of coal,

- immediately build heaps of controversial (public oppinion- wasteful)reactors

- or wait until all alternatives (public oppinion non controversial-cleaner) alternate methods have been investigated fully.

In this way, I wish to show that (eg 'public opinion') has a reasonable (scientific) leg to stand on upto this point, and then if it is shown that there is no other viable option to obtain the required results from investigations, then it is purely a matter of ethics as to proceed or not or benefit from the knowledge gained by those that do, and that this perhaps is the debate as it stands in essence, as medical knowledge once gained by any means is definately going to be used by all in the long run. Thinking about this I might just paint the spectrum of oppinions and how they each believe they are doing the right thing in regards to a particular research topic.

example.
(rough draft)
'in contrast to the controversy involved with the use of embryonic stem cells, research (reference information gained from Scientific American.com) has been conducted into stem cells gained from amniocentesis. Political,public and scientific (give examples) oppinion has supported amniotic fluid stemcells (AFS) because no embryo is used in obtaining these pluripotent cells (reference ScietificAmerican.com). The debate continues because researchers believe that AFS can be just as effective (will outline reasons) for research as those obtained from Embryos(ref, ScientificAmerican.com). Dr.(refs) sees this as a positive however Dr.(refs) states that there is no doing without embryonic stemcells because, but it can be seen that AFS research has much to offer according to institute ... (refs)"AFS can provide all etc etc. without the need to clone embryos(refs)". Religious and philosophical groups such as. support AFS for this reason.(refs)

this is an example of how I would structure the arguement..

hope this is all on track. see you in the lab

will post links shortly.

--[[User:Z3292208|z3292208]] 23:45, 15 August 2010 (UTC)

okay so I'll do 1 & 2, mark 3&4, 5,6,? if you think it's too much I don't mind picking up 5, let me know.

Tegan.

--[[User:Z3254753|Mark Woods]] 22:21, 15 August 2010 (UTC)
yea, i can do 3 and 4 thats a good split :)

Mark

--[[User:Z3292208|z3292208]] 22:11, 15 August 2010 (UTC)

Im happy to do the first 2? 5 and 6 arent too big so maybe someone can do the last 3? and then someone do 3 and 4 (Mark if you wanted to do that?). Do you think thats a fair split?

Tegan.

--[[User:Z3254753|z3254753]] 13:08, 15 August 2010 (UTC)

hey guys,
nice work with the refernces, I think those sub catagories work well.
I've been looking for references, Im not sure how to link it but I was on pubmed n found something that could work for current research, its actually an alternative to amniocentesis.
I figured we could use it to compare the two, and discuss why they're looking into an alternative.

[[http://www.ncbi.nlm.nih.gov/pubmed/20542474|Current and emerging techniques of fetal cell separation from maternal blood]]

As for dividing up tasks, we should do that asap. I wouldn't mind getting to sink my teeth into what genetic orders can be detected, and I'm up for any other.

statistics-

[[http://www.ncbi.nlm.nih.gov/pubmed/20533279|Study on population-based prenatal screening and diagnosis of Down's syndrome]]

[[http://www.ncbi.nlm.nih.gov/pubmed/20192924|Correlation between serum biochemical markers and early amniocentesis in diagnosis of congenital fetal anomalies.]]

accuracy - [[http://www.ncbi.nlm.nih.gov/pubmed/20308831 | Accuracy of real-time polymerase chain reaction for Toxoplasma gondii in amniotic fluid. ]].

ethics -

[[http://www.ncbi.nlm.nih.gov/pubmed/18990991|Ethical considerations]].

Mark

--[[User:Z3292208|z3292208]] 06:27, 15 August 2010 (UTC)

Here are some links to start off:

'''Historic background:''' http://www.ob-ultrasound.net/amniocentesis.html

'''Procedure:''' http://www.mjbovo.com/Pregnancy/PregAmnio.htm

'''Risks:''' http://www.wisegeek.com/what-are-the-risks-of-amniocentesis.htm

Main risks include 1) Miscarriage or pre-term labor, statistics have reduced in recent years. 2) Infection through the needle to the mother. 3) If the placenta is accidentally pricked mixing of neonatal blood and mothers blood may occur causing a condition where the mothers immune system attacks the fetus as a foreign body. This occurs due to a difference in blood type, one being Rh-positive, one being Rh-negative, although this can be tested before the procedure (checking the parents genotype) and extra care can be taken. 4) Harm to the baby from the needle, but ultrasound reduces this significantly.

Risk of miscarriage is less than 1% according to http://www.genetics.com.au/pdf/factsheets/fs17c.pdf.

'''Disorders detected:''' Amniocentesis takes a sample of the amniotic fluid containing fetal skin cells, from these they can look at the baby's chromosomes and detect any chromosomal disorders such as Down syndrome, trisomy 13 and trisomy 18. The sample taken can be tested for neural tube defects by looking at the amount of the protein alpha-fetoprotein (AFP), e.g. spina bifida and anencephaly (disorder where the top end of the neural tube fails to close during week 3-4 of development leading to portions of the brain and skull not being formed, usually leading to death before birth or very soon after).
http://downsyndrome.about.com/od/diagnosingdownsyndrome/a/Amnio_ro.htm
http://www.anencephaly.net/anencephaly.html

--[[User:Z3292208|z3292208]] 08:46, 12 August 2010 (UTC)

Hey guys so I've rethought the structure a bit and added some detail that we should look into:

'''1. Historic background:'''

- When was it first used?

- How was the technique developed?

- The key scientists involved.

- Trends in its use.

'''2. Procedure'''

- Who is eligible for the procedure?

- Are there women/couples more suited to the test? (e.g family history in genetic disorders or previous birth with a genetic defect)

- When is the test taken during pregnancy?

- How is the procedure performed? Method, steps involved.

'''3. Risks'''

- Side effects, complications, short and long term (short term like infections, long term possible effects to the baby, abortion or induced early birth?)

- Could do an advantages/disadvantages table maybe?

'''4. Disorders detected'''

- What components of the amniotic fluid do they isolate and analyse, and what do they test for? (I read that there are a few hundred disorders that they can test for but the parents and doctor only choose certain ones for them to test, and also there are some main ones so maybe we'll just pick the most common ones and do those, e.g. chromosomal disorders like Down syndrome and neural tube defects like spina bifida).

'''5. Diagnostic accuracy'''

- How accurate is the testing, statistics.

'''6. Ethical issues'''

- Professional and public opinions about the test, is it a more common diagnostic technique?

'''7. Current research'''

- Is there any current research being done to improve the procedure? There may not be...

What do you guys think? If there's anything you think we should add post it up top (apparently we're supposed to post new things at the top of the page) if not then we should think how to split up the workload so we can start getting into it.

Tegan.

--[[User:Z3292208|z3292208]] 00:14, 12 August 2010 (UTC)

Areas to look into:

1. Historic Background

2. Procedure, method.

3. Complications

4. Benefits, what disorders can be detected and prevented, option of abortion.

5. Current research on the procedure

Anything else you guys can think of to include?

--[[User:Z3254753|z3254753]] 00:33, 12 August 2010 (UTC)

nice work!
i think '4.Benefits, what disorders can be detected and prevented, option of abortion' would be a big one, maybe whoever takes that one just has that point, and the other two ppl take two points each?
what do you guys think?

hi everybody!

--[[User:S8600021|Mark Hill]] 22:56, 11 August 2010 (UTC) Well group 3 where is your work that should have been done before this week's Lab?

Talk:2010 Group Project 3

2010-10-06T04:57:37Z

Z3254753:

--[[User:Z3254753|Mark Woods]] 04:57, 6 October 2010 (UTC)

hey, nice pic 312, hopefully permission comes through soon

--[[User:Z3292208|z3292208]] 04:31, 6 October 2010 (UTC)

What did i say that wasnt nice? Anyways yeah that picture looks good for your section, it would go well with your info. Hopefully you can get the permission.

312

so whats the answer then ?

--[[User:Z3254753|z3254753]] 04:05, 6 October 2010 (UTC)

thanks tegan =)

--[[User:Z3129413]] 03:58, 6 October 2010 (UTC)

312

anyone there ? alrighty... now look at Fluorecent in situ hybridisation on wikipedia you will see a picture of glowing chromosomes .. I am asking permission to use this on the page right now ... actually not just this picture but a few other ones that are bigger.

--[[User:Z3292208|z3292208]] 02:22, 6 October 2010 (UTC)

Hey also guys this is a link to the marking criteria and main points we need to have in the assignment so check it out and see if there's anything that needs fixing or adding?

[[2010 Lab 1|Marking criteria]]

--[[User:Z3292208|z3292208]] 02:16, 6 October 2010 (UTC)

312 said he'd be on top of it all by 2200hr today. uuum yeh i dunno what pictures would fit, maybe some sort of graph about the accuracy over time or compared to other techniques would be awesome but it takes time getting permission and its the day before so not sure what to do.

How to reference with multiple instances on a page is all on this page: [[References]]

--[[User:Z3254753|z3254753]] 00:00, 6 October 2010 (UTC)

Also, we should think bout maybe adding a picture or two to 312's sections. Thing is, its hard coming up with ideas of pictures that are relevant :S can u guys think of anything?

How do I reference the same thing in different parts of the page?

--[[User:Z3254753|z3254753]] 23:36, 5 October 2010 (UTC)

Yup no worries. Ive got info there already on miscarriage, il move it around a bit and add to it. Good thinking about this as a key difference. Ill probly have it as my first sub heading.

Ive bin looking into my chromosomal abnormalities section, different sources say different things about catagorizing conditions, gotta make sure its all correct :S

thanks tegan

--[[User:Z3292208|z3292208]] 22:25, 5 October 2010 (UTC)

hey amniocentesis was the main heading of the page lol so i left that and the intro at the top, and moved the comparison with CVS to the bottom of the page as a wrap up i guess.

hey also mark are you gonna put an extra subheading in risks for miscarriage? i reckon it'd be good to highlight that risk as its one of the main ones you read about and that links into the comparison with CVS as thats one of the points that differs them. what do you reckon?

--[[User:Z3254753|z3254753]] 09:02, 5 October 2010 (UTC)

heya, how do u guys feel about putting amniocentesis after current research? i think itll b a great way to "end" the page, comparing this with cvs.

What do u guys think? i cud b way off on this one haha

--[[User:Z3254753|z3254753]] 05:01, 5 October 2010 (UTC)

yea gud thinking, il redo mine, n add a few more n base it on mark hill's, then reference elsewhere if needed.

--[[User:Z3292208|z3292208]] 00:09, 5 October 2010 (UTC)

I took glossary terms from Mark Hills glossary on this website, other terms i took from the internet and referenced, i think thats better to do and its not hard.

have a look at other groups pages to see their copyright statements to get an idea maybe?

--[[User:Z3254753|z3254753]] 21:33, 4 October 2010 (UTC)

hey 312, im pretty sure u hav to provide the statement, or give the details of its copyright which shows u can use it legally.

in the glossary it seems we can use our own words as long as its clear? wat do u guys think? i think is a good idea, it will show we actually do kno wats going on.

honestly, i was a little surprised to get an email back, she got back to me within a couple of days. But, she sed it was fine, thanked me for asking n wished me all the best haha

mark

--User:Z3129413.
yeah Bro that's awesome (about getting the written permission), did it take long to get a reply? My question for the moment is how to format the copyright info in the statement box, like if its an Image off wikipedia and it has those copyright statements GNU and commons and all that do I have to actually provide an as is copy of that statement ? Its damn hard to find free technical genetic/cytology pictures. I will figure it out anyhow.

That's a very good question about glossary defs, whats the go? maybe we should ref those as well? seems excessive, format the explanation in terms of what is already been referenced in the main text.

Im going to work towards 1500hr Wed as everything pretty much wrapped up for me, with time to change things around till about 2200.

--[[User:Z3254753|z3254753]] 11:50, 4 October 2010 (UTC)

do we make up glossary definitions ourselves?

--[[User:Z3254753|z3254753]] 08:54, 4 October 2010 (UTC)

hey guys, sorry bout the late reply, i just got bak from work.

yup, i will do the copyright n summary for the tree diagram, one of my pictures i got written permission, i emailed prof. anne david, is the copyright info for that ok?

mark

--[[User:Z3292208|z3292208]] 06:36, 4 October 2010 (UTC)

You have to add a copyright statement if its from another website or if its one of your own pictures, all the details are on the editing page:

[[Editing Basics]]

I think its due thurs, not 100% sure.

--[[User:Z3129413]] 06:29, 4 October 2010 (UTC)
yeah thanks bro, 325 ... the copywrite statement that is contained on wikipedia when one clicks on the image is that what we have to include in the summary... hey did you actualy get written permition for the use of one of your images 325 ? thats awesome.. alrighty so the page is due on thurs is it not?

--[[User:Z3292208|z3292208]] 06:17, 4 October 2010 (UTC)

Hey also for the picture you uploaded when you click on it you can add a description there for it and also you need to add a copyright statement, have a look at my diagrams and copy it off that.
Disorders is looking good, the detail is good.

--[[User:Z3254753|z3254753]] 10:07, 3 October 2010 (UTC)

haha no worries tegan, im also redoing the abnormalities so theres more in the paragraphs, kind of expanding on the tree diagram
il hav all my upadtes, n more referencing by either late tonight or tomo =)

mark

--[[User:Z3292208|z3292208]] 10:03, 3 October 2010 (UTC)

Hey mark the tree diagram is good but make it a bit bigger on the page? and yeh put the terms in the glossary.

--[[User:Z3254753|z3254753]] 00:27, 3 October 2010 (UTC)

hey current research is good =) u know what I just thought, this section is a great place to have some external links, maybe to a couple of different research reserach teams websites or something. What do you think?
N its meant to be for the peer level, so im sure its fine to go a bit deeper if u think u need to.

also, im making a tree diagram with pretty technical terms, should i emplain the terms here or just put their definitions in the glossary?

n thats unlucky bout the saints, dw, im sure ull get them next yr =)

z3129413

I like the amnio vs cvs discussion
I dont know but are abortions painful? increasing by degrees of lateness of pregnancy increasing safety (true?) but does this also mean that abortion is less painful the earlier it is done?
I think they mean that amniocentisis is an invasive procedure because it is physicaly sticking a needle into someone, not
invasive as in 'intruding on privacy'.
I am going to put a few pictures up tonight.
Can I have some feedback on the current research section please? too brief ?, If page is supposed to be for the layman then current research is going to get pretty technical from here on in.

--[[User:Z312941]] 09:22, 27 September 2010 (UTC)

Nah Mark told me anyhow about the extension, I just didn't really believe it sorta you know.. Anyhow Saint Kilda possibly winning the Grand final was far more interesting than pretending this web page actually means shit. Tell me what have you actually learnt yourself about current and future trends in genetic testing ? Oh that was my topic.. but what did you learn ? did you bother to get on pubmed and follow all the twists and turns of the articles to understand where its all at now ? you did ? .. then why aren't you
going
Hey I read this fantastic thing on FISH or what ever the other night.. man its got me buzzed... yknow.. that would be more fun.. see this is the problem with university these days its all about missing the big picture for a lot of people. Anyway you are my colleague, we are friends, I am always ready to talk about science and football. This page will get done, and on and on it goes. I learnt a heap out of it. hope you did too. The instructor said it was a lot of fun and for me it was. I am really glad I now know how to use pubmed and stuff because now I can get on with learning stuff for myself which is fun. I didn't disappear who ever you are 3292208... I was on call - I actually am on call most of the time... you will get a job some day and enjoy being on call too, way the world is....

Hey yeah scientific feed back sure that's groovy... whatya know?

I have seen the sources you might have used for your sections and basic stance it was all pretty much ladle from one pot to the other no? maybe we can make that less not subtle.

Anyhow I do have a few little cool bits to add to my sections and all will see what you have when you have it all there and happening..

hey Uni is fun no?

--[[User:Z3292208|z3292208]] 22:41, 26 September 2010 (UTC)

thanks for finally putting your sections up, very very relieved! But i totally forgot to tell you after you disappeared in the lab last week Mark H told us he extended the deadline for a week or so. But i guess its a good thing i forgot to tell you since you did it last minute again now we at least have time to read through it and give you some feedback and finish doing some final touch ups to the page. And now you have time to get some good pics up on your section. I definitely think it would be good to break up the text with pictures, it makes it alot more accessible as a web page.

--[[User:Z3129413]] 22:05, 26 September 2010 (UTC)
well there you go, got it done grand final and all Go the Saints ! Anyway at the expense of looking like I havent wrote too
much I have yes kept it brief.. What is there is many hours of reading pubmed papers the information is factual... Anyone want to chuck in a Fluorescent in situ hybridisation picture in my diagnostic accuracy section for me, that would be really excellent but its hard to find a free one... picture of blue and green glowing chromosomes... you guys have done a really good job... I think it all works together... I was planning on doing a bit more
at lunch time today... is that passed the cut off? I will read this again at about 11 30.. will try to find a few more pics. I put a few things in the glossary.
I think anyone can understand what amniocentesis is about from the page,... I sure do not want to hear that word for a very long time now. Its not too technical.. Good work.

--[[User:Z3292208|z3292208]] 09:14, 26 September 2010 (UTC)

Hey guys just a reminder to add any scientific words to the glossary at the bottom of the page. Also yeah i think we should aim to make this accessible to someone without a background in embryology or even science, so keep it clear, concise and easy to understand :)

--[[User:Z3254753|z3254753]] 13:54, 25 September 2010 (UTC)

,thanks heaps for the suggestions, il work on it =) i thought i did include how rarely problems occur?

i dont think we should include expenses or talk about state health care.

time delay n intro suggestions are both really good.

types of infections are good, but do u want me to go that technical?

i found iodine to be mostly used, but il include the ones, also a good idea, thanks.

glossary is where we will define terms

hopefully u can upload ur sections soon.

Here is one last thing to note; I dont know if u guys were there, but i talked to dr hill after the last lab and he was clear about these things; keep it clear, concise and dont make a 5000 word page for the sake of it, we will get marked down.

I really like what weve done, i think we'll hav an impressive project =)

Mark

--[[User:Z3292208|z3292208]] 01:10, 25 September 2010 (UTC)

Hey also guys you should both check this site out

http://www.plus-size-pregnancy.org/Prenatal%20Testing/prenataltest-amnios.htm

Mark i know you used it for part of your risks section but there's more detail on the site that you could add to your section, i just pulled some more detail off it for my parts.

Also there's some good information on that site for ethical issues and accuracy which you should really check out!

Tegan.

--[[User:Z3292208|z3292208]] 09:04, 24 September 2010 (UTC)

* So you want me write more specifically what type of needle they use?
* I dont know what you want us to write in the introduction, can you explain it better?
* I dont think we should down play the risks, the risks are there no matter how often they occur, we need to explain them, then its our job to show how reliable the procedure is in DIAGNOSTIC ACCURACY. We can say that its relatively safe compared to the other techniques, although there is a small chance of complications due to these risks, and outline them.
* When you talk about "how many cases of deaths from infections..etc" do you think we should write for each risk the occurence rate of them? That could be something worth looking into. Of course all invasive procedures have a risk of infection, and yes the chance of the fetus getting hit by the needle is small (since they use ultrasound) we still need to mention and explain all the possible risks.
* I mentioned in my procedure section that there is a delay in recieveing the results, read through it.
* For those terms mentioned = aneuploidy, trisomy etc, i said we are adding a glossary to the bottom of the page. Feel free to contribute terms from your section, when it is up.
* "We should mention somewhere that Gammaglobulin must to be given to at risk rhesus factor mothers in regard Kleihauer." What does this sentence mean?
* For diagnostic accuracy i think we should mention the possibility of false results - false positive or false negative results. The outcomes of these could be discussed in ethical issues - i.e. a mother aborting a pregnancy thinking there is an abnormality, or a mother not terminating the pregnancy thinking there are no defects, but the baby is born with a disorder.
* Also for diagnostic accuracy, the one reference that is there is from a study of a second trimester amniocentesis, although some are performed during the first trimester, so maybe see if the accuracy is different for the 2? Also it would be good to show trends in accuracy over time, has it improved since the use of ultrasound in the 70's?

Tegan.

--[[User:Z3129413]] 04:02, 24 September 2010 (UTC)
Hello friends so lets get this scene
together and make it groovy for Monday,

Typos and my syntax suggestions for
approval:

format: as is vs (suggestion)

Thin needle (hollow amniocentesis needle of commonly of between 21-22gauge at 120, 150, 90 mm length, there are pictures of these and a 10cc syringe)

Lets say straight off in the intro something like
(following routinely offered prenatal screening blood tests, FTS 10 weeks to 13 weeks 6 days of pregnancy and ultrasound or if missed Second TS blood test 14 to 18 weeks of preg,
diagnostic tests such as amniocentesis can be elected by mother although this is invasive etc
it is highly accurate, refs etc department of health)

I don't know it could be my interpretation but can we downplay the risks associated as the studies
I have read have put amniocentesis when performed with care as really safe

Numerous risks (sounds too broad as infection, harm to the baby (lets use the word foetus) and anxiety
(do you mean also pain to mother)is only three.

How many cases of deaths form infections resulted from amniocentesis are there, a few, many,
proven nosocomial contamination from non sterile equipment,
would this relate to the factor of state of health care available
as opposed to amniocentesis being risky per se,
statistics of proven foetal deaths from skin flora contaminating the womb.

What are the names of skin flora potential pathogens, throw a few of those term around cant hurt, staphylococci, MRSA
gets back to state of health care facilities.

But all invasive procedures by default are risky in terms of infection.

Could we change the use of Iodine solution to simply say area is (stringently disinfected) although I have
read many blogs etc and web pages that have mentioned Betadine, Iodine etc, but I do not know what is used routinely these days with the advent of new hospital pathogens, from my micro experience and having needles they use alcohol swabs, not much grows in that kind of alcohol. We cant say for certain that only Iodine solution can be used before amniocentesis, unless you know otherwise of course, something like that is used before surgery so it might be absolutely correct to say so but this would need references.

I read a web page that outlines the physical trauma that has been caused very unfortunately and I would say
mostly blamelessly to the technicians of such things as foetal optical penetration by the 20gauge needle,
but this is very rare, it doesn't happen everyday, amniocentesis is safe.

Even a minute chance of physical harm to the foetus is enough to blow most peoples minds though, but the Dr is trained to guide a patient through all that.

Seems the big two are chance of miscarriage (minor) and pain of the needle.

Do we mention anaesthesia enough,

How do we rate amniocentesis in terms of risk compared to other invasive diagnostic proceedures.

Anyhow here's a start whilst Im putting my stuff together,
will check back in awhile

This is what I mean by simplistic.

there's typos here and there also.

Peace.

also do we mention to date there is a time delay in getting results, expense of getting results, substantial technical expertise needed by cytogenetics laboratory to perform tests

I think we want to add trisomy 13. as pubmed in 'Future of prenatal cytogenetic studies,rapid aneuploidy testing or full karyotype- a study
13, 18, 21 testing due to this constituting 65-85% of all chromosomal abberations

In disorders detected can terms aneuploidy be defined, can trisomy, monosomy be stated

In diagnostic accuracy we have
Traditional cytogenetic techniques that I will outline and how amniocentisis is important in
providing the material for these tests which gives I would say has the 94% accuracy for diagnosing aneuploidy

vs

The new wave of QF- PCR testing that gives I think about a 97% diagnostic accuracy
A traditional full karyotype can be done or a shortened test is an option, giving quicker turn around times with less expense and anxiety in anticipating results.
so that's the progress that accuracy is taking.
Diagnosing amniotic fluid for genetic aneuploidy is the gold standard.

Current research will be the increasing interest in using PCR techniques.

Mentioning Stem cell research is too off track

The ethics section will be broken into

.Due to the offering of this invasive proceedure
Anxiety to mother due questions of whether it is right or wrong to undergo amniocentisis
from the perspective of procedural potential harm to foetus, and
termination of pregnancy, information gained leading to opening option of abortion.
I will state the current laws that govern current medical actions, such as
the need for the provision of genetic counsel.

We should mention somewhere that Gammaglobulin must to be given to at risk rhesus factor mothers in regard Kleihauer.

Check in with you later tonight or tomorrow.

--[[User:Z3292208|z3292208]] 00:42, 24 September 2010 (UTC)

Hey guys so this is what i think we should change for the final assessment:

# Glossary
# More referencing throughout.
# Add some external links if we find some good sites, or to a video.
# Add a timeline to the history section.
# Add a tree diagram to the disorder section.
# Add a section comparing all the techniques.
# Diagnostic accuracy needs to be added to.
# Ethical issues needs to be broken down from a large paragraph and referenced, and made more clear.
# Current research needs to be added to.
# Look into getting some more pictures.
# Some more risks could be added to the risk section.

What do you think? Did i miss anything, you think thats all we need to do?

Hey also i changed the headings in the page from bold to actual subheadings so that they all show up in the contents at the top of the page.

Just putting this here for myself:

http://www.ncbi.nlm.nih.gov/pmc/articles/instance/1011338/

http://www.genetics.com.au/pdf/factsheets/fs17c.pdf

Tegan.

Thankyou!! :) - Jill --[[User:Z3265772|z3265772]] 11:58, 23 September 2010 (UTC)

--[[User:Z3292208|z3292208]] 02:57, 23 September 2010 (UTC)

Hey Jill yeah sure you can use it, as long as you reference me as the artist! yeah i think thats a good idea too adding a comparison between the different techniques, we're definitely gonna add something similar. enjoy :)

Hi Guys! I was just wondering if i could please get your permission to use your student drawn diagram, if you see our [[2010_Group_Project_2|page]] im making a table with all our diagrams in it, and, of course, i need your permission to use it :) Thanks! Jill - group 2 --[[User:Z3265772|z3265772]] 02:53, 23 September 2010 (UTC)

==Peer review==

Group 3: I thought your page was very thorough and informative especially the procedure section, plus the way in which you have structured the information with concise subheadings keeps it easy to understand. Only thing is that the page lacked a glossary section which would really help the reader understand the concepts better if added. A very good use of table and pictures throughout to keep the content engaging all the way through. To improve the page, perhaps you could talk about the advantages of amniocentesis and even compare it to other techniques. Maybe you could also expand the section on current research by exploring the future prospects of this technique? but overall really good effort.
--[[User:Z3293029|z3293029]] 15:15, 22 September 2010 (UTC)

Group 3 - significant research into your topic evident on the page, so well done. The Abnormalities table is both concise and informative. The table along with the hand drawn images and other images makes the page more aesthetically appealing to the reader. I learned quite a lot about this procedure in one sitting which is a credit to your work.
A few improvements would be to reference the Ethics and the Disorders Detected sections, maybe break up the text with the use of more tables and dot points which would simplify the content a little as it appears to be very technically dense. A glossary would help your audience in understanding the content more easily and maybe adjusting the jargon so that it's not so scientific but more conceptual. Again, like others have mentioned, some editing in terms of grammatical and spelling errors is needed throughout the page. Good effort. --z3241780 13:53, 22 September 2010 (UTC)

'''GROUP 3: Amniocentesis'''

This project is the probably in my opinion the most scientific of all the project pages, but there are point where I felt that if I didn’t have an academic science background I would have got lost. Yet the information presented on the webpage is extremely informative and the structure of the page makes it easy to follow. Referencing for the first few sections is fine but towards the end I find that there are not as many references. The pictures which include the hand drawn pictures are really good and they help break the information into smaller section allowing time to process the information above. Like every other group there are a few spelling mistakes here and there but like I’ve stated on everybody’s pages you will pick them up on your final check. As well I noticed that you don’t really have a proper glossary and I think putting one in would be beneficial but this is just a small suggestion. Apart from that I can’t criticise the assignment. I personally think after reading your assignment the standard of my groups’ assignment should be lifted. You can really tell you have put in a tonne of effort. Well Done Guys!!!

--[[User:Z3252635|z3252635]] 13:22, 22 September 2010 (UTC)

Hi guys!

You have a great distribution of your pictures around the page, it really breaks up the text and makes it easier to read and to look at. I noticed a few spelling/grammar errors throughout your page, though (e.g. “likelihood of baring a child” – it should be bearing) so you might want to proofread it a couple of times. It would make your text easier to read, too – your information is great but sometimes I had to read over bits a few times where the grammar was a little fuzzy. I think you’ve used the table really well to describe disorders detected by amniocentesis. Also, good job of putting the copyright statement with your student-drawn diagrams. Well done!--[[User:Z3252833|z3252833]] 12:44, 22 September 2010 (UTC)

Group 3 = I really like the photos used especially the hand drawn ones and they project is very easy to read and follow. There are alot of references which indicated some serious research .

What could be improved - although everything is already beautiful glossary and timeline(for history)would be better..other than that everything is fantastic.--[[User:Z3305561|Navneet Ahuja]] 12:48, 21 September 2010 (UTC)

Group 3: amniocentesis
I found this project very interesting and it was very well written, by far it had a more scientific feel than the others. All of the images and tables were relevant and informative. I felt that I learnt plenty about the particular diseases that the diagnostic technique could find as there was plenty of detail on this.

What could be improved?
Probably some more pictures from sources other than Wikipedia.

--[[User:Z3254433|z3254433]] 07:17, 20 September 2010 (UTC)

Hi Guys, This project is very well written, and also easy to follow. i really, really, (really!) liked the disorders section, with the table, graph and pictures it made it really easy to follow, and interesting! when you see a picture like the anencephaly one, it makes you stop and read what its about! I also like how many student drawn diagrams there are, you have really put in a lot of effort. I definitely learnt a lot from reading this page, Thanks!

What could be improved: The ethics section has no references, also the current research section seems to be copied straight from the internet, be careful with this, while it is referenced in one part, it is still plagiarism to copy and paste, you need to re write in your own words and reference. there are also a few spelling mistakes in the ethics section - waranted=warranted, phsychological=psychological

--[[User:Z3265772|z3265772]] 23:41, 20 September 2010 (UTC)

--Group 3 Amniocentesis

This group has shown a vast knowledge of the topic and has more than enough information from a number of sources. The diagrams that were hand drawn were very effective and clear to help the reader gain an understanding of the topic. On what can be improved: The size of the headings could be a little bigger to be more clear, also the same with the pictures, use them to break up the paragraphs which will make the page easier to read and take in the information. Thanks guys you did great.

--[[User:Z3290040|3290040]] 10:19, 22 September 2010 (UTC)

This project was very well written and highlighted the main points of amniocentesis. The structure of it was very clear which made it easy to understand and follow. I feel that it was a good project addressing students and people who don't know much about this area.

What could be improved is that there were no references in the ethics section which may be a problem. Also a glossary may be needed at the end of the page.

--[[User:Z3291079|z3291079]] 03:04, 21 September 2010 (UTC)

This project is very informative and did a good job in stating what the test is about and explainning how it is carried out. I really like the uses of sub-headings making it very easy to follow. However I feel that there are too little information in the accuracy of the diagnosis although the percentage is quite high, using only one study to support the accuracy does not seem to be convincing enough.

What I think could be improve would be looking up a meta-study which compares the studies done on amniocentesis to provide more information about its accuracy and how reliable it is with respect to the various disorders which it can detect.

--[[User:Z3216889|3216889]] 12:27, 22 September 2010 (UTC)

I personally found the introduction to resemble that of an essay; I don't think an outline of what the webpage consists of is completely necessary seeing as there is a table of contents. A Glossary and proof reading are also needed. Other than that Your web page is great. The table of disorders that you have included is encompassing and simple enough to easily follow. It s a very well-rounded overview of Amniocentesis and I congratulate you on a job well done!--[[User:Z3252083|z3252083]] 12:30, 22 September 2010 (UTC)

Page layout was nicely organised! It had logical flow and was simple to understand. History was covered well, and prodedure was explained very thoroughly and was quite scientific yet simple about the information on what happens in the lab, ie. karotyping. The student drawn images were drawn really well and shows good amount of effort that has been put into them and it supplemented the text really well. The pie chart and the picture I found was very eyecatching and made me more interested to read about the topic. Ways to improve is to expand on the current research and add a glossary at the end. Overall good job!
--[[User:Z3224500|z3224500]] 12:51, 22 September 2010 (UTC)

----

{{Template:Projects10MHtal

--[[User:Z3292208|z3292208]] 01:55, 16 September 2010 (UTC)

Actually guys you know what I just realised. '''VERY IMPORTANT''' PLEASE READ THIS:
Mark (Hill) told us that peer assessment was due today and we're not allowed to edit the page until the peer assessment is over which is next thursdays lab. Meaning we only have from next thursdays lab, '''23rd''', to the following monday, the '''27th''' to finish the page.

This is why we were supposed to have our projects pretty much finished for today and only adjust it slightly in response to the peer assessments. So '''312''' you'll have '''4 days''' after next thursday to finish your sections and allow us to look at it to give you feedback in case it needs to be further edited before the FINAL assessment.

This is going to be a very tight squeeze since you havent done anything before this morning. That is why i may have seemed harsh in my response because we have very limited time and it isnt fair to us to have contributed so late to the due date.

Tegan.

--[[User:Z3292208|z3292208]] 01:45, 16 September 2010 (UTC)

Yes the previous years had more than 400 edits, this project is due in a week and a half (11 days!) and compare the amount of edits me and mark have done to how many you have done. I hope this will be enough time for you to finish your sections and allow us to have a look at it in advance to the due date and give you feedback as its a group project and we are supposed to help each other. Me and mark and have given each other feedback on our sections and helped each other to make it better, I think that is what makes a successful group project - working together.

If you think the rest of the project is too simplistic tell me where my parts can be changed and ill look into it. The introduction is meant to outline the assignment and I think that's what i did. The procedure section clearly outlines every step of the procedure, I even went into the detail of the analysis of the amniotic fluid in the lab (including a diagram i drew) which I was worried was too technical for people without knowledge of the topic to understand but Mark assured me it was good and clear. I asked everybody for their opinions last week, Mark replied and told me he found it easy to understand but it had enough detail. Read it and tell me what you think.

Ethical issues, no matter how complicated it is, can still be written in a clear and concise format, with clear issues that are introduced then elaborated on with references to back up the argument. Sub headings can be used I think that would break up a big section of text well, thats what I used in my sections.

Are the drawings okay? It was the best I could do, I think I showed the procedure clearly and it complements the relevant sections. Do you have any ideas about pictures for the other sections? Are you going to include any pictures in yours?

Tegan.

--[[User:Z3129413]] 00:47, 16 September 2010 (UTC) Thankyou 3292208 duly noted. Categories will be edited and valid criticism and typos will be corrected. I found your introduction and subsequent sections lacked some scientific feel, in fact the whole page overall is rather too simplistic in my opinion. This of course can be edited as can the work I have done. Outlining Ethical issues as Im sure you are aware is rather more complicated than merely introducing the subject and listing how the proceedure is conducted, and that I have been trying to find the best way in which to present this, however I thankyou for suggesting the way in which it could be done, this will have to be considered when I edit my work. I did see that previous pages have had upwards of 400+ edits BEFORE the FINAL submission. I hope we can all edit our work to make it better which of course will be done way before the due date.

--[[User:Z3292208|z3292208]] 19:33, 15 September 2010 (UTC)

as much as im grateful you're finally putting something on the page doing it this late, a few hours before its due, doesnt give us any time to give you feedback for it.

Since im awake though for Diagnostic Accuracy one study isnt enough to give a final say about the topic, you still have to make an overall judgement of the accuracy of the procedure or even show that its become more reliable through trends over time.

Ethical issues needs to be structured in a more clear and concise format, its too much writing in one block and isnt clear to the point. Its hard to tell what your key points of argument are. I also dont think using questions to the audience is a good idea, you should more so just be presenting the issues to be thought about but using hard evidence to present them instead of using rhetorical questions to just put the ideas out there. You should also mention one of the KEY ethical issues about amnniocentesis = ABORTION. Theres also no references in that section.

In current research that paragraph reads exactly like in the article you referenced, we have to write it in our own words or its plagiarism. And whilst copying it you made a mistake the article says the stem cells do NOT form tumors in vivo (whatever that means which should be explained on the project page) and you wrote that they do form tumors.

I hope you'll at least edit it more than a few hours before the final assessment is due.

See you in the lab.

--[[User:Z3254753|Mark Woods]] 11:14, 15 September 2010 (UTC)

yea soz lack of references is my bad, i havnt dont it this week coz i kinda got a mid session on friday ive bin concentrating on.

c u tomo =)

--[[User:Z3292208|z3292208]] 11:09, 15 September 2010 (UTC)

Yeah i think its looking good, slight lack of references but we can fix that after i guess. and we should prob polish it up a bit and make sure it reads heaps smoothly but we can do that after i guess. hmmm missing sections does not look good tho! looking forward to seeing everyone at the lab tomorrow. see u then

--[[User:Z3254753|z3254753]] 10:31, 15 September 2010 (UTC)

ok last nite before peer review, do we need anythin else to do? i think it looks very gud for peer review, besides the missing sections:S we can change and add after peer review of course

--[[User:Z3254753|z3254753]] 13:23, 14 September 2010 (UTC)

yea. dont worry, mayb its just my computer lol

--[[User:Z3292208|z3292208]] 10:55, 14 September 2010 (UTC)

The actual heading "Risks"? It looks normal on my page...

--[[User:Z3254753|z3254753]] 09:26, 14 September 2010 (UTC)

nah its better like that :)

another lil detail i tried to fix was that the "risks" heading is pushed over from the picture. how do we fix that?

--[[User:Z3292208|z3292208]] 06:07, 13 September 2010 (UTC)

Hey also hope you dont mind i made ur pie pic a little bigger cos i thought it would look good like that but feel free to change it back if you want!

--[[User:Z3292208|z3292208]] 03:38, 13 September 2010 (UTC)

Oh sorry lol i forgot to tell u, he mentioned it in the last lab

Hey also that pie diagram you put in maybe make it as a thumbnail and add a caption to the bottom of it saying what it is?

Cant believe out of all the disorders mentioned you had to put that picture up!

--[[User:Z3254753|z3254753]] 00:19, 13 September 2010 (UTC)

omg y ddnt u tell me! i thought we had to hav it done for peer assement today :S. thats much better though =)

--[[User:Z3292208|z3292208]] 22:13, 12 September 2010 (UTC)

Hey mark your section is looking good.

I really dont think we should put those other sections up they dont read well at all.

Also mark said to us in the last lab that you missed that the beginning of this thursdays lab is the last time we're allowed to edit our pages and from then the peer assessments start and we have until the following lab to assess everyone elses group project so we have until then, hopefully before then we'll get a reply back from mark or . And also other groups have missing sections so they must have people missing too

--[[User:Z3254753|z3254753]] 13:52, 12 September 2010 (UTC)

so this is what i have, i think its gud enough for peer assessment. I plan to add more to disorders, both chromosomal n neural tube defects are gonna get more info on the main ones. I also want to expand on my table with more disorders and student made drawing of tree diagram catagorizing chromosomal defects.

Tegan, do you think this is enough for tomorrow?

And im ripping straight from the discussion page just to have something other the other headlines, it will b more embarrassing to have blank sections, so i figured well throw in wat he was planning to write

--[[User:Z3254753|z3254753]] 11:01, 12 September 2010 (UTC)

yes they can be, such as Klinefelter's syndrome, i think thats wat i sed isnt it?

he got bak to my first email from like wednesday last week n sent an email, i hav since sent a couple of msgs which hasnt resulted in anything, i dont know wat to do!

--[[User:Z3292208|z3292208]] 10:25, 12 September 2010 (UTC)

Hey i read the chromosomal disorders bit you added about translocations etc, cant disorders also be genetic like sex linked diseases carried on the X chromosome?

Has mark gotten back to you at all? He's away this week too which is a bugger...

And yes a very nice moustache lol

--[[User:Z3254753|z3254753]] 04:46, 12 September 2010 (UTC)

dr murray barr had a glorious moustache lol

--[[User:Z3254753|z3254753]] 03:00, 12 September 2010 (UTC)

haha yea it makes things a little easier :) just check out wen looking wat kind of licensing it has

--[[User:Z3292208|z3292208]] 02:46, 12 September 2010 (UTC)

Oh geez why couldnt you warn me before! yeah thats heaps good, so much easier.

--[[User:Z3254753|Mark Woods]] 02:44, 12 September 2010 (UTC)

Check out the copyright details

http://en.wikipedia.org/wiki/File:Enencephaly.jpg

yes i guess its not straying from the topic.

--[[User:Z3292208|z3292208]] 02:27, 12 September 2010 (UTC)

I dont think thats straying too far at all cos those are the exact things amniocentesis prevents so it just shows how useful the procedure is!

actually pics of what goes wrong during amniocentesis would be good too (i.e in risks).

how can you use that photo? cos its from wikipedia? hmmm.... giving me some ideas lol

--[[User:Z3254753|Mark Woods]] 02:10, 12 September 2010 (UTC)

It freaked me out too! We can actually use that image on our page if we want lol thanks for the picture ideas.

I will be expanding on the disorders section, and its a good idea to include photos of ppl wit the ssyndromes look like. Im only concerned about straying to far from the amniocentesis topic?

--[[User:Z3292208|z3292208]] 01:56, 12 September 2010 (UTC)

Omg mark i was just looking at the links you put in your disorder table (thats really cool by the way) and i looked at the Anencephaly one, did you see the pic on that page??? freaked me out lol

hey but also are you gonna put more detail under that section too?

--[[User:Z3292208|z3292208]] 01:50, 12 September 2010 (UTC)

Hey mark,

Oh forgot to mention that article just lists those complications it doesnt actually go into any detail about them.

Uum not sure what to do about the missing sections, I could email 312 using his student email, is everyones just their student number then @unsw.edu.au?

Yeah speaking of pictures i found it really hard getting permission for pictures, thats why i drew a couple but i still want to try find one of the scientists. Yours i think would be better getting pics of people affected by the disorders you talk about? what do you think? Or you could find one maybe of the neural tube and showing the top and bottom which is closes in normal development. just some ideas.

--[[User:Z3254753|z3254753]] 01:36, 12 September 2010 (UTC)

thanks tegan, il do that today
also, wat r we gonna do about the missing sections? :S

i emailed dr mark bout it but he hasnt gotten bak to me

also, any ideas forstudent drawn pics i could hav in my sections?

--[[User:Z3292208|z3292208]] 11:07, 11 September 2010 (UTC)

Hey Mark

I just read in an article i was reading they make a comment about risks and they list a few but highlight that there are risks for the fetus and risks for the mother:

# Fetal complications = deaths from abruptio placentae,infection, fetal haemorrhage, and puncture of the fetus.
# Maternal complications = maternal haemorrbage, peritonitis, rhesus isoimmunization, and premature labour.

http://www.ncbi.nlm.nih.gov/pubmed/4255487

If you wanna have a look and maybe add to your section?

--[[User:Z3292208|z3292208]] 02:44, 11 September 2010 (UTC)

Yeah more detailed paragraphs sounds good, but as a summary the table is spot on.

--[[User:Z3254753|Mark Woods]] 02:41, 11 September 2010 (UTC)

yea i no wat u mean, ive confused myself a bit with wat is actually relevant to put in. I was gonna hav an intro, but how bout also paragraphs explaining the main ones? thats better place to puts pics of the chromosomal disorders n stuff.

--[[User:Z3292208|z3292208]] 22:21, 10 September 2010 (UTC)

hey mark,

table looks good, i thought it might be more detailed but i guess that covers everything. you should put some more references in though, im still working on mine, and also you referenced a website i used a couple times, on the how to reference page there's a way to put multiple references in the page from one link so check that out.

also some pics would be cool for the disorders if you could find them? im gonna try find some pics for my history section, im in the process of getting permission to use a picture of cells with a Barr body, the part that shows the sex of the fetus, which Murray Barr discovered.

Oh and yeah maybe put a column in for Type thatd be good.

Anyways our page isnt looking as good as last years! i guess its missing a third of it though...

--[[User:Z3254753|z3254753]] 03:56, 10 September 2010 (UTC)

guys im working on the table, im not sure bout the columns, maybe i shud have Disorder, Type(chromosomal), Cause, Diagnostic rate using amniocentesis?

suggestions?

also tegan, maybe a headshot of a couple of the scientists? ur section looks finished, so that idea is only if ur at home bored :P

--[[User:Z3254753|z3254753]] 02:16, 10 September 2010 (UTC)

u guys shud check out all the intructions just to make a table haha

--[[User:Z3254753|z3254753]] 00:36, 9 September 2010 (UTC)

aight il hav most of disorders done tonight, but il put it on the project page tomo

thats kinda what ive bin doin, i gave a lil intro to it before the table.

--[[User:Z3292208|z3292208]] 22:38, 8 September 2010 (UTC)

Hey mark yeh a table is a good idea how about having quite a simplified table first just showing the different chromosomal and neural tube defect just as a little summary then after it have headings and go into all the detail? you could also add a picture column in the table for each disorder? or put that with the bulk of info either way i guess. sounds good tho!

Hey 312 how are you going with your section? Im getting worried not seeing a draft or anything of yours since its due monday! Let us know how you're going please!

Tegan.

--[[User:Z3254753|z3254753]] 06:16, 8 September 2010 (UTC)

hey guys,

with disorders, I was thinking bout doing a table. ive got an intro n separate the disorders into chromosomal abnormalities and neural tube defects to talk bout in paragraph form, but i was thinking of a table to show the different disorders. what do you think?
Or do u think i shud stil go through the main ones individually n then hav the table?

also, a table wud break up all the paragraphs :P

--[[User:Z3254753|z3254753]] 08:42, 7 September 2010 (UTC)
yea, its stil not working, cud b somethin wit my computer not sure. its just not letting me edit the project page, im tryin to put the refernces in to risks.

which is also weird coz im having no trouble rditing this discussion page.

--[[User:Z3292208|z3292208]] 07:20, 7 September 2010 (UTC)

Are you testing the page mark? lol. still having troubles with the site?

--[[User:Z3254753|z3254753]] 07:08, 7 September 2010 (UTC)

hey, the added section is great. I was gonna go through wat is being looked for for each of the disorders i look at (e.g the presence of an extra 21st chromosome). for some reason its not letting me change my risk section, so ill keep going with my other section n come back to it and itll hopefully work.

--[[User:Z3292208|z3292208]] 07:00, 7 September 2010 (UTC)

Just putting this here for myself:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2035329/

--[[User:Z3254753|z3254753]] 07:03, 7 September 2010 (UTC)

haha just read through it, yea the sentence cuts out, thatnks for proof reading. ill check out ur section soon, my computer has decided it doesnt want to open our project page

--[[User:Z3292208|z3292208]] 06:46, 7 September 2010 (UTC)

Hey also i added more detail to the end of my procedure section just about how they treat the sample once it gets to the lab and chromosome mapping etc, do you wanna read it and tell me if it makes sense to you and isnt too much science lingo or hard to understand at all?

Thanksss

--[[User:Z3292208|z3292208]] 06:44, 7 September 2010 (UTC)

Yeah that sounds good you can still have a section on miscarriages and just mention that it is the common result of all the other complications. Just to make it a bit clearer for people who dont know anything about it.

But yeh it looks good otherwise! yeah that one line i was just like what that doesnt make sense lol

Oh and i just mean that sentence about the mothers immune response did you forget something on the end of it or something? I just dont understand it is all

--[[User:Z3254753|z3254753]] 06:40, 7 September 2010 (UTC)

whoops that was from the draft lol i confused myself reading the study.

and i kinda rushed my section on the rhesus factor, i just went off wat ive learnt before. il go back over and make it more clear.

I wasnt sure whether to make miscarrages its own section because its connected to all the risks, its like the ultimate bad result for all the risks, thats why i thought it should go in the intro.

I will fix up the intro, seperating into actual introduction and miscarriages, wat do u think?

--[[User:Z3292208|z3292208]] 06:30, 7 September 2010 (UTC)

Hey also what did you mean in the top bit where you said "This cannot be attributed to the procedure of amniocentesis."?

--[[User:Z3292208|z3292208]] 06:28, 7 September 2010 (UTC)

Hey I had a look, looking good. That first section though it sort of was a bit confusing when i first read it, maybe put an intro to risks and then a subheading just about miscarriages and what causes them (uterus contracting etc) and put those stats in there? The physiological risks is really good, its really clear and easy to read.

This sentence doesnt really make sense when i read it:

"A transfer of blood would stimulate an immune response by the mother against the different blood type, the result being that the mother’s own immune system."

But yeah other than that its good!

Tegan.

--[[User:Z3254753|Mark Woods]] 06:17, 7 September 2010 (UTC)

just uploaded risks. definitely needs pictures or something to break up the text.

wat do u guys think?

--[[User:Z3292208|z3292208]] 04:02, 7 September 2010 (UTC)

Yeh i dont mind slipping it into mine unless you can elaborate on it and it fits well in yours? Maybe we can decide once both sections are up and have a look. But in that article in the results section its got some good statistics for you about still births and miscarriages.

--[[User:Z3254753|z3254753]] 03:55, 7 September 2010 (UTC)

thanks for the reference help :)

and i think it does fit better under eligibility, it works under my section as well because its about reducing unnecessary risk, but in this case we should keep it all together.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2464303/

look through this and see whether it fits in your section, no rush.

--[[User:Z3292208|z3292208]] 03:42, 7 September 2010 (UTC)

Dammit i dont know how to put the reference in without it making an actual reference lol but have a look in the edit version!

--[[User:Z3292208|z3292208]] 03:40, 7 September 2010 (UTC)

Okay so here is what you put in the page where you want the reference <ref><pubmed>XXXXX</pubmed></ref> but you put the pubmed article number in the middle and when you save it all the details appear at the bottom reference section on the page.

That abstract is good, i guess from that we can say something like "As observed in a study carried out in the period 02-05 it can be seen that an increased risk of Down syndrome is a major reason that most women choose to take the amniocentesis test, compared to suspicious ultrasound findings which was not listed as the basis for many womens choices. And then reference that article.

But about that, where it says "increased risk of Down syndrome" do they mean increased risk due to the mother being over 35? If you reckon thats what they mean we should probably write that instead, like write the cause of the increased risk you know.

But yeh not sure did you want to add this into your risk section? Do you think it fits? I can put it in my section where i covered whose eligible for the procedure and you can focus more on the risks and the things that could go wrong like miscarriage and all that. What do you think?

--[[User:Z3254753|Mark Woods]] 03:26, 7 September 2010 (UTC)

this is an abstact:

This is a retrospective review of case notes of all pregnant women undergone amniocentesis in our department during the period 2002-2005. Two main operators performed the procedure, using 22 gauze needle usually and 20 gauze should longer needle was needed. Sevendy three patients undergone amniocentesis. The reasons for having this procedure were: increased risk for Down syndrome in 68% (50/73), maternal request in 24% (18/73), suspicious ultrasound findings in 4% (3/73) and family history in 3% (2/73). Maternal age ranged from 20 to 45 years and the gestation time that amniocentesis was performed was 15 to 23 weeks. Fluorescence in situ hybridization (FISH) and culture were used in order to obtain karyotype results

--[[User:Z3292208|z3292208]] 03:40, 7 September 2010 (UTC)

What do you mean, percentage of mothers having children over 35 and women with histories of genetic disorders and all that? Like statistics from a specific study?

For pubmed references go to the page in edit version and have a look at what i put for it, you copy and paste that and just put in the pubmed number for the article you used where the number is in the middle. The other references you have to write it out but have a look at the how to reference on the site down the left hand side.

--[[User:Z3254753|z3254753]] 03:19, 7 September 2010 (UTC)

ur rite about repeating urself. I found some research where they give percentages of occurence of each reason. I guess this allows me to be slightly more specific or technical which is should be expected from my section. what do you think.

how did u do the references?

--[[User:Z3292208|z3292208]] 03:50, 7 September 2010 (UTC)

Hey Mark thats looking really good! The emotional state of the mother part is heaps good i didnt realise you could find out specific hormones but thats really interesting. That beginning bit though about the guidelines present to assess whether a mother is in a top priority for the procedure I covered in my section so maybe we shouldnt repeat ourselves or it will sound a bit repetitive? I guess you could just mention there are certain women more suited to the procedure due to the number of risks but maybe focus more on what causes the miscarriage if it occurs?

Also we can put more than one student drawing but i think we need at least one. We do need more pictures in it though.

Hey 312, how are you going with your section?

Tegan.

--[[User:Z3254753|z3254753]] 14:25, 6 September 2010 (UTC)

general outline for risks.

Risks
There are risks involved in the procedure of amniocentesis. There is a chance, however small, of a miscarriage As stated before, only certain people should undergo the procedure because of these reasons. This involves:
• Maternal age is considered, women older than 35 are at a higher risk of having children with chromosomal disorders.[2]
• History of chromosomal disorders in the family, testing if the parents are Rh positive or Rh negative.[3]
• History of previous children born with a genetic defect.
These guidelines allow for properly measuring the risk of the procedure against knowledge that can be gained from it. A doctor or genetic counsellor should be consulted prior to the test.

Timing

Amniocentesis should be performed at a time when enough amount amniotic fluid can be taken for diagnosis without affecting the course of the pregnancy. Generally, this is around weeks 15 -19. As indicated under the procedure section.

Infection

There is a risk of infection with amniocentesis. It is intrusive as it requires contact to be made with the amniotic fluid by a needle through the skin, abnormal wall and uterine wall. The transfer of bacteria can occur if the needle and area of needle insertion into the lower abdomen of the woman are not properly sterile.
This risk is lowered by all persons involved in the procedure properly washing their hands and working in a sterile environment. Swabbing the area where the needle is inserted is the most common method of keeping these areas clean.
This also leads to the possibility of transfer of blood plasma from the foetus to the mother. This can cause major issues in the instance where the rhesus (Rh) factor of the baby is positive and the mother is negative. A transfer of blood would stimulate an immune response by the against the different blood type, the result being that the mother’s own immune system.

Foetal contact

The chance of the needle hitting the developing foetus is a risk factor. This can be avoided by constantly using ultrasound o see the position of the developing foetus.
Psychological Risks

The emotional state of the mother can have affects on the outcome of the pregnancy. Learning if the baby has conditions can lead to an emotional state such as depression and anxiety. These are the effects of results that amniocentesis gives these social issues. These can elevate levels of certain hormones which imbalances the pregnancy such as citrol, influencing concentration levels of others in the blood, activating receptors, release of adrenaline, effects on blood pressure and nutrient supply to the baby.

tegan, i stole one of ur paragraphs, just coz it fit so well. il change it wen i put it on the assignment page. il better explain the hormonal changes due to stressed, thats fine. Ill put this up on the page, along with its references n then disorders by thursday night.

Risks are covered pretty well in ur procedure section Tegan, so i refer to it a few times :P

--[[User:Z3254753|z3254753]] 23:38, 5 September 2010 (UTC)

hey the drawing is really good!

Did we only need one student drawing?

--[[User:Z3292208|z3292208]] 03:51, 7 September 2010 (UTC)

Hey yeh it was good, altho only half the class turned up.. The week after the break we have a new lecturer whose taking the lectures and lab too. Let me know if u think the drawing I did is ok :)

--[[User:Z3254753|z3254753]] 06:35, 3 September 2010 (UTC)

how was the lab yesterday guys? soz i missed it

--[[User:Z3292208|z3292208]] 00:43, 2 September 2010 (UTC)

history links:

* http://www.ncbi.nlm.nih.gov/pubmed/13114925 - '''The Pattern of Haemolytic Disease of the Newborn
'''
* http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1799312/

* http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1050098/pdf/jmedgene00080-0015.pdf

* http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1806475/pdf/bullnyacadmed00267-0043.pdf

procedure links:

* http://www.nature.com/scitable/topicpage/karyotyping-for-chromosomal-abnormalities-298

* http://www.nlm.nih.gov/medlineplus/ency/article/003935.htm

--[[User:Z3254753|z3254753]] 22:48, 1 September 2010 (UTC)

N yea uploading mine in the mid sem break =)

--[[User:Z3292208|z3292208]] 09:28, 31 August 2010 (UTC)
Hey Mark the breakdown for risks and disorders looks like a good structure, looks like you'll cover everything.

--[[User:Z3129413|Z3129413]] 01:05, 31 August 2010 (UTC)z3129413
will be working on page all day wed and will be online here.

--[[User:S8600021|Mark Hill]] 00:46, 31 August 2010 (UTC) You have the major headings and some content added to some sections (but not all) on your project page. I cannot see any additional resources, images that you have sourced from other scientific sources, nor the student drawn figure. You need to have this updated before this weeks lab when I will be reviewing all projects.

--[[User:Z3254753|z3254753]] 00:51, 30 August 2010 (UTC)

so this is how I've divided up my sections further

risks:
for each risk;

what is it? Why is this a risk (eg infection, hitting the fetus)

how is this risk reduced?

At which stage is performing amniocentesis most risky.

Stats of how often problems have arise in pregnancy connected to amniocentesis

Disorders:
I can't just write a whole thing on each, as much as I'd like to, it'll b like having a whole section on disorders, not amniocentesis.
So For each of the main disorders:

intro-discription, rates in birth

what stage of pregnancy can this be detected?

how it is tested for / detected

what do they look for? Eg variation chromosomes

why do they look for this? This mite belong in ethics but by this title I mean why do they test for this genetic disorder.. Is there some level of seriousness in a family history that warrants this test.. They test for each thing individually once they hav the amniotic fluid sample.

Suggestions?

--[[User:Z3292208|z3292208]] 05:59, 29 August 2010 (UTC)
Hey guys just wanted to remind you this is due 2 weeks tomorrow ok!

--[[User:Z3292208|z3292208]] 03:57, 26 August 2010 (UTC)

Hey Mark I put on the page a picture of trisomy 21, Down sydrome, to slot in the disorders section.

--[[User:Z3292208|z3292208]] 11:10, 25 August 2010 (UTC)

Picture of the procedure:

http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=mga&part=A1760&rendertype=figure&id=A1761

http://adam.about.com/encyclopedia/Amniocentesis_1.htm

Picture to put in from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2532964/

--[[User:Z3129413]] 08:15, 25 August 2010 (UTC)

Thanks 325.

--[[User:Z3254753|z3254753]] 07:45, 25 August 2010 (UTC)

yea bro, il bring my camera tomo.

--[[Z3129413]] 06:06, 25 August 2010 (UTC)z3129413
The page layout is awesome... Anyone have a digi camera at the moment can you bring it thurs/fri.. can get some snapshots for the page... return camera next lab if feasible...

--[[User:S8600021|Mark Hill]] 04:39, 23 August 2010 (UTC) Ok you guys have been doing some talk here. Now is the time to start thinking how to populate your project page subheadings. Remember that anything you do can always be undone or altered at a later date. I also see an absence here of good visual material for your project.

--[[User:Z3292208|z3292208]] 02:01, 19 August 2010 (UTC)

'''History'''

Key scientists:

*'''Douglas Bevis'''
** His study of mixing Rh +ve and -ve blood and of hemolytic disease was a key event in making the technique well known.
** Hemolytic disease in newborns occurs when the mothers antibodies attack the fetal red blood cells, the antibodies cross the placenta to the fetus as the mother helps to strengthen the growing fetus's immune system, in which doing so may do the opposite.
** http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=rbcantigen&part=ch4
** http://www.discoveriesinmedicine.com/A-An/Amniocentesis.html
*'''Murray Barr''' and '''Ewart Bartram'''
** In the 50's the use of amniocentesis was used to find out the sex of the baby, not originally to diagnose chromosomal or neural tube defects.
** 1949 were the first to study if the sex of a fetus can be found using amniocentesis anaylsis, and with that the possibility of sex linked diseases like hemophilia (a disorder of blood clotting).
** The way the sex could be found = female cells have a cellular body attached, called the Barr body or sex chromatin, and male cells don't. This extra body, the sex chromatin, can be seen under the microscope.
** Until amniocentesis in the 1950's, the only diagnostic technique used to warn women of having a child with a sex linked disease would be statistics based on family history, which was nothing more than loose probability.
** Therefore is the sex of the baby could be found out pre-birth (along with the genomes of the mother and father of certain disorders), more reliable statistics could be calculated as to whether their baby might have a sex linked disorder.
** http://www.ohiostatepress.org/books/Complete%20PDFs/Rothenberg%20Women/05.pdf
* '''Fuchs and Riis'''
** 1956 they were the first to successfully determine the sex of a baby using amniocentesis by the presence of a Barr body.
* '''Steel and Breg'''
** 1966 noted that amniotic fluid cells were able to be karyotyped, chromosomes can be analysed.
*'''Dr. Carlo Valenti''' = 1968 first to use amniocentesis to diagnose a chromosomal/inherited disorder.
* 1980's ultrasound techniques took out the guess work to guiding the needle during the procedure.

'''Procedure'''

''Who is eligible for the test?''
* Since the procedure is invasive and therefore not without a number of risks, numerous tests are taken before to decide whether the mother is in the top category of women with a high chance of having a child with chromosomal or neural tube defect disorders.
*These pre tests include:
** Checking for abnormal ultrasound features
** Maternal age is considered (>35 high risk of chromosomal disorders)
** History of chromosomal disorders in the family, Rh +ve/-ve of the parents.
** History of previous children born with a genetic defect.

''When can the test be taken?''
* Most commonly during 15-16 weeks of gestation (during the second trimester), but can be done between weeks 14-20.
* Second trimester amniocentesis is between weeks 15-18 (commonly wk 15-16).
* Early amniocentesis is in the first trimester between weeks 11-14.
** Has shown to have a rate of 3 times the rate of miscarriage.
** Early amniocentesis has been conducted since the delay in the tissue analysis of an average of 2 weeks means if abortion is the option taken it is physically harder for the mother at a later stage of pregnancy, and emotionally as well.
** The more common time is during second trimester since there is less risk of miscarriage and complications, and if an early diagnostic test is requested, CVS is a more recommended option.
* Tissue culture takes a further 2-3 weeks before a result can be found.

''Steps of the procedure''
* Counseling for the mother = review of genetic family history and history of any birth defects in previous children of the mother. Mother is also informed of the risks associated with the procedure, and is able to make a decision to continue based on weighing up the risks with her personal calculated chance of having a fetal abnormality.
* Area is cleaned before needle insertion with an iodine solution.
* Local anesthetic may be used but since there is little pain it usually isn't used to avoid having a second needle insertion.
* Needle inserted and 15ml fluid taken, takes approx 30 seconds to withdraw the fluid.
* Before the needle is inserted and whilst the needle is inside the uterus ultrasound is used to avoid harm to the baby and placenta.
* After fluid is taken the baby's heart beat is checked to ensure there was no harm.
* Fluid is cultured, the chromosomes are mapped = called karyotyping.
* http://www.nevdgp.org.au/info/melb_us/Amniocentesis_melb.htm
* http://www.plus-size-pregnancy.org/Prenatal%20Testing/prenataltest-amnios.htm
* Amniotc fluid taken out is centrifuged at 4000 rpm for 15 minutes and then filtered. The filtrates are then scanned in a recording spectrophotometer.

'''Note:'''
* For '''diagnostic accuracy''', comparing this technique to other techniques, I read that Chorionic Villi Sampling (CVS) can be used earlier on in the pregnancy, but the disadvantage of that is there is a greater risk of miscarriage. So there is a pro and con for amniocentesis against CVS.
** Also i just thought to include in '''diagnostic accuracy''', what about the occurrence of false positive results?? Are there any statistics relating to false positive cases, if there have been cases what were the outcomes, has there been any incidence of abortion as a result of a false positive for a disorder? (That could be an '''ethical issue''' too, are women more wary of the procedure in case it isnt 100% reliable and there is a chance of false positives?).
** Have a look at this site too for '''diagnostic accuracy''', there's a whole section which looks really useful, it says that even if the results of the test are 'normal' doesn't guarantee a normal baby, it also explains how some chromosomal tests can be ambiguous and an unsure diagnosis can result leaving mothers with uncertainty. http://www.plus-size-pregnancy.org/Prenatal%20Testing/prenataltest-amnios.htm
* For '''risks''', Evidence supporting the 1% risk of miscarriage statistic in the article http://www.ncbi.nlm.nih.gov/pubmed/18923654
** Another '''risk''', could the stress and anxiety for the mother before the procedure be harmful to the baby? Added stress and anxiety in the chance of an abnormal result and possible abortion? Seems like a small point but I found an article about it so thought I'd let you have a look. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2859418/
** Mark also have a look at this site, it has a whole detailed section on '''risks''' which looks really good: http://www.plus-size-pregnancy.org/Prenatal%20Testing/prenataltest-amnios.htm

--[[User:Z3254753|z3254753]] 23:17, 18 August 2010 (UTC)

Another point on ethical issues is the ethical decisions to be made if a problem is found. Is it ethical to terminate a pregnancy if it is found the child will have mental retardation? What factors are involved when making these choices? I don't think there is a right answer for everybody, so maybe its important in this section to present ethical arguements for all sides.

So yea, I think you've covered all the ethical issues, nice work!

Mark

--[[User:Z3292208|z3292208]] 23:06, 18 August 2010 (UTC)

For ethical issues i was thinking more along the lines of is the test too invasive for the mother? Not necessarily the risks (thats being covered separately) but would many women be unsure about the procedure because it is invasive and possibly painful, do people believe there are other techniques that could be as effective and more attractive to women. In this we could also do a brief comparison between amniocentesis and other diagnostic techniques, the positives and negatives of the procedure against others.

Also another ethical issue would be the choices the mother would make if a positive test of a disorder was found.

Tegan.

22:54 August 18
Z3129413: Yes tasks outlines are good. Diagnostic accuracy according to NATA guidelines can be accessed quite easily. NATA is the testing accrediting agency in Australia, which monitors pathology labortory testing accuracy in accordance to intesively reviewed set guidlines. Any lab operating wants to have NATA accreditation in order to display the logo on request forms etc. I think that all hospitals outsource genetic and pathology testing to semi or fully private companies which can also be part of the government health service. Those labs that are aligned with hospitals, usualy those located on the hospital campus itself, are all absolutely operating in accordance with NATA guidlines. The further question here is what are the inherant diagnostic inaccuracies associated with amniocentesis itself, if any? I dont know at this stage. Another question is , can amniocentesis be conducted in private rooms by a clinic, GP or other? Therefore are patients attending here protected by some sort of accreditation monitoring agency?
I think leaving the diagnostic accuracy to involve only Australia is relavant, as it can be safe to assume that in places where medical proceedures are commonly understood to not generally fall below a certain standard, what happens in Australia applies to them also as the medical information and research is shared between these locations via published research studies from various universities etc. and are used by the various national accrediting agencies as reference material in formatting the guidlines.
I will look into accessing the current plus or minus degrees of error and reference ranges used to diagnose the top most test requested for.

In tackling the last two topics,

A).
Ethical issues and current research perhaps can tie in together (an option)
- as at a glance I do not think there is much controversy surrounding the test per se,
other than in terms of potential physical trauma to mother or infant due to accident at time of proceedure or malpractice, possibly instrument sterility issues re bacteria introduced into womb or abdominal wall. In light of the risks associated ( therefore proceedural ethics) in this regards,I will have to weigh it up with investigating if there are simple blood tests that can accurately diagnose the same tests requested from an amniocentesis. But this will be covered by 3. RISKS.

Alternate proceedures for the tests could be covered by 'Diagnostic accuracy' I will have to look into this. Maybe other proceedures (blood tests) are more accurate for some tests.
so lets call that safety/ accuracy concerns. Maybe not to bring ethics into this at this point.

Propose '5.Diagnostic accuracy and efficiency'.

Propose '6.Outcomes from results'
Of course there is the issue of receiving a positive test result. I can cover this as the 'medical outcomes' of the tests (what it allows the parents to do in light of the knowledge). Here is a major source of ethical debate.

Propose '7.Current research trends and ethical debates'
State main streams of current research and the place they are being conducted, in order to highlight the fact that there may be differing laws govering research restrictions.
give a brief outline of current laws (probably sourced from UN. I will aim to give specific examples of where public oppinion has opposed proposed research ideas. If it appears that personal related morality versus 'yes it is proceedurally ethical(safe to mother etc)' I will state that opinions differ in this regard. I will outline the purposes of the research and by then aiming to show any alternate methods of approaching the same research, if any, the ethical debate can then be structured in this way.
For now I think this is the best way to approach this.

ie, research says yes switch to uranium to alleviate the use of coal,

- immediately build heaps of controversial (public oppinion- wasteful)reactors

- or wait until all alternatives (public oppinion non controversial-cleaner) alternate methods have been investigated fully.

In this way, I wish to show that (eg 'public opinion') has a reasonable (scientific) leg to stand on upto this point, and then if it is shown that there is no other viable option to obtain the required results from investigations, then it is purely a matter of ethics as to proceed or not or benefit from the knowledge gained by those that do, and that this perhaps is the debate as it stands in essence, as medical knowledge once gained by any means is definately going to be used by all in the long run. Thinking about this I might just paint the spectrum of oppinions and how they each believe they are doing the right thing in regards to a particular research topic.

example.
(rough draft)
'in contrast to the controversy involved with the use of embryonic stem cells, research (reference information gained from Scientific American.com) has been conducted into stem cells gained from amniocentesis. Political,public and scientific (give examples) oppinion has supported amniotic fluid stemcells (AFS) because no embryo is used in obtaining these pluripotent cells (reference ScietificAmerican.com). The debate continues because researchers believe that AFS can be just as effective (will outline reasons) for research as those obtained from Embryos(ref, ScientificAmerican.com). Dr.(refs) sees this as a positive however Dr.(refs) states that there is no doing without embryonic stemcells because, but it can be seen that AFS research has much to offer according to institute ... (refs)"AFS can provide all etc etc. without the need to clone embryos(refs)". Religious and philosophical groups such as. support AFS for this reason.(refs)

this is an example of how I would structure the arguement..

hope this is all on track. see you in the lab

will post links shortly.

--[[User:Z3292208|z3292208]] 23:45, 15 August 2010 (UTC)

okay so I'll do 1 & 2, mark 3&4, 5,6,? if you think it's too much I don't mind picking up 5, let me know.

Tegan.

--[[User:Z3254753|Mark Woods]] 22:21, 15 August 2010 (UTC)
yea, i can do 3 and 4 thats a good split :)

Mark

--[[User:Z3292208|z3292208]] 22:11, 15 August 2010 (UTC)

Im happy to do the first 2? 5 and 6 arent too big so maybe someone can do the last 3? and then someone do 3 and 4 (Mark if you wanted to do that?). Do you think thats a fair split?

Tegan.

--[[User:Z3254753|z3254753]] 13:08, 15 August 2010 (UTC)

hey guys,
nice work with the refernces, I think those sub catagories work well.
I've been looking for references, Im not sure how to link it but I was on pubmed n found something that could work for current research, its actually an alternative to amniocentesis.
I figured we could use it to compare the two, and discuss why they're looking into an alternative.

[[http://www.ncbi.nlm.nih.gov/pubmed/20542474|Current and emerging techniques of fetal cell separation from maternal blood]]

As for dividing up tasks, we should do that asap. I wouldn't mind getting to sink my teeth into what genetic orders can be detected, and I'm up for any other.

statistics-

[[http://www.ncbi.nlm.nih.gov/pubmed/20533279|Study on population-based prenatal screening and diagnosis of Down's syndrome]]

[[http://www.ncbi.nlm.nih.gov/pubmed/20192924|Correlation between serum biochemical markers and early amniocentesis in diagnosis of congenital fetal anomalies.]]

accuracy - [[http://www.ncbi.nlm.nih.gov/pubmed/20308831 | Accuracy of real-time polymerase chain reaction for Toxoplasma gondii in amniotic fluid. ]].

ethics -

[[http://www.ncbi.nlm.nih.gov/pubmed/18990991|Ethical considerations]].

Mark

--[[User:Z3292208|z3292208]] 06:27, 15 August 2010 (UTC)

Here are some links to start off:

'''Historic background:''' http://www.ob-ultrasound.net/amniocentesis.html

'''Procedure:''' http://www.mjbovo.com/Pregnancy/PregAmnio.htm

'''Risks:''' http://www.wisegeek.com/what-are-the-risks-of-amniocentesis.htm

Main risks include 1) Miscarriage or pre-term labor, statistics have reduced in recent years. 2) Infection through the needle to the mother. 3) If the placenta is accidentally pricked mixing of neonatal blood and mothers blood may occur causing a condition where the mothers immune system attacks the fetus as a foreign body. This occurs due to a difference in blood type, one being Rh-positive, one being Rh-negative, although this can be tested before the procedure (checking the parents genotype) and extra care can be taken. 4) Harm to the baby from the needle, but ultrasound reduces this significantly.

Risk of miscarriage is less than 1% according to http://www.genetics.com.au/pdf/factsheets/fs17c.pdf.

'''Disorders detected:''' Amniocentesis takes a sample of the amniotic fluid containing fetal skin cells, from these they can look at the baby's chromosomes and detect any chromosomal disorders such as Down syndrome, trisomy 13 and trisomy 18. The sample taken can be tested for neural tube defects by looking at the amount of the protein alpha-fetoprotein (AFP), e.g. spina bifida and anencephaly (disorder where the top end of the neural tube fails to close during week 3-4 of development leading to portions of the brain and skull not being formed, usually leading to death before birth or very soon after).
http://downsyndrome.about.com/od/diagnosingdownsyndrome/a/Amnio_ro.htm
http://www.anencephaly.net/anencephaly.html

--[[User:Z3292208|z3292208]] 08:46, 12 August 2010 (UTC)

Hey guys so I've rethought the structure a bit and added some detail that we should look into:

'''1. Historic background:'''

- When was it first used?

- How was the technique developed?

- The key scientists involved.

- Trends in its use.

'''2. Procedure'''

- Who is eligible for the procedure?

- Are there women/couples more suited to the test? (e.g family history in genetic disorders or previous birth with a genetic defect)

- When is the test taken during pregnancy?

- How is the procedure performed? Method, steps involved.

'''3. Risks'''

- Side effects, complications, short and long term (short term like infections, long term possible effects to the baby, abortion or induced early birth?)

- Could do an advantages/disadvantages table maybe?

'''4. Disorders detected'''

- What components of the amniotic fluid do they isolate and analyse, and what do they test for? (I read that there are a few hundred disorders that they can test for but the parents and doctor only choose certain ones for them to test, and also there are some main ones so maybe we'll just pick the most common ones and do those, e.g. chromosomal disorders like Down syndrome and neural tube defects like spina bifida).

'''5. Diagnostic accuracy'''

- How accurate is the testing, statistics.

'''6. Ethical issues'''

- Professional and public opinions about the test, is it a more common diagnostic technique?

'''7. Current research'''

- Is there any current research being done to improve the procedure? There may not be...

What do you guys think? If there's anything you think we should add post it up top (apparently we're supposed to post new things at the top of the page) if not then we should think how to split up the workload so we can start getting into it.

Tegan.

--[[User:Z3292208|z3292208]] 00:14, 12 August 2010 (UTC)

Areas to look into:

1. Historic Background

2. Procedure, method.

3. Complications

4. Benefits, what disorders can be detected and prevented, option of abortion.

5. Current research on the procedure

Anything else you guys can think of to include?

--[[User:Z3254753|z3254753]] 00:33, 12 August 2010 (UTC)

nice work!
i think '4.Benefits, what disorders can be detected and prevented, option of abortion' would be a big one, maybe whoever takes that one just has that point, and the other two ppl take two points each?
what do you guys think?

hi everybody!

--[[User:S8600021|Mark Hill]] 22:56, 11 August 2010 (UTC) Well group 3 where is your work that should have been done before this week's Lab?