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Introduction: Ultrasound-guided bipolar umbilical cord occlusion (UCO) is used in complicated monochorionic multiple pregnancies in Denmark. The aim of this study was to assess a learning curve in the procedure of UCO. Materials and Methods: One hundred and two monochorionic pregnancies treated with UCO at Rigshospitalet, Denmark between 2004 and 2015 were included. The procedures were divided into period 1 (2004-2009) and period 2 (2010-2015) to determine a learning curve. Primary outcome measure was survival rate. Secondary outcome measures were time from operation to fetal loss and gestational age (GA) at delivery. Results: Period 1 included 59 cases. The median GA at procedure was 19.9 weeks (range 16.7-25.9) and at delivery 34.7 weeks (range 24.3-40.3). Period 2 included 43 cases. The median GA at procedure was 20.7 weeks (range 16.7-27.6) and at delivery 37.3 weeks (range 29.1-40.3). Survival rate increased from 78% (period 1) to 95% (period 2) (p = 0.02). GA at delivery increased as well. Fetal death within 48 h after surgery decreased from 4 (period 1) to 0 (period 2). Discussion: Our results suggest a learning curve in the procedure of UCO with improved outcome on all measures.

Bacterial and viral contamination of touch surfaces allows for transmission of pathogens leading to increased risk of infection. Previous work has demonstrated the antimicrobial properties of copper for contact-killing of microbes for use in hospitals. Less research exists on copper as an antiviral surface and on the effects of nanomaterial copper surfaces in the contact-killing of viruses. Nano agglomerate and conventional copper powder feedstock is used in the cold spray process to form copper coatings on aluminum substrates. The nano and conventional copper surfaces formed are tested for antiviral contact-killing of influenza A virus. After a two hour exposure to the surfaces, the surviving influenza A virus was assayed and the results compared. The differences in the powder feedstock used to produce the test surfaces were examined in order to explain the mechanism that caused the observed differences in influenza A virus killing efficiency. Results showed that the nano copper surface was antiviral, but less effective than a study on antimicrobial killing of MRSA on copper surfaces. The nano copper surface was more effective at percent reduction of influenza A virus than that of conventional copper. It was determined that the work hardening caused by the cold spray process in combination with the high number of grain boundaries results in a copper microstructure that enhances ionic diffusion. Copper ion diffusion is the principle mechanism for microbial and viral destruction on copper surfaces. Testing determined significant microbiologic differences between nano- and conventional Cu surfaces and demonstrates the importance of nano copper surfaces as an antiviral agent. The nano agglomerate powder shows superior antiviral effectiveness to that of conventional Cu due to an increase in grain boundaries at the nano level. Further research is needed to determine the effects of nano and conventional copper surface roughness on the contact-killing rate of viruses versus microbes on both a micro and nano-scale.

Normal ranges of amniotic fluid alpha-fetoprotein (AFP) and acetylcholinesterase activity (AChE) are described for gestational weeks 11-14 using rocket gel immunoelectrophoresis for AFP quantitation and a monoclonal antibody (4F19) enzyme antigen immunoassay for AChE activity measurement. The normal ranges were established by the examination of 281 amniotic fluid samples from 281 normal pregnancies. AFP was found to increase from a median level of 14.0 MIU/l at 11 weeks to a maximum at 13 weeks (median = 18.0 MIU/l) (P < 0.05), thereafter falling (not significant). No AChE test result exceeded 4.8 nkat/l. In addition, AFP and AChE values for three cases of fetal malformation, identified by the biochemical analyses of amniotic fluid, are given. These cases included two fetuses with a neural tube defect and one fetus with an abdominal wall defect. Amniocentesis was performed at 10, 11, and 14 weeks, respectively. The AFP and AChE values were all high.

In 2004 The Danish National Board of Health introduced a new guideline regarding prenatal screening. All pregnant women are now offered a Down's syndrome risk assessment. The new guideline has had an impact on the number of invasive early prenatal procedures. The number of procedures fell by 50% from 2000 to 2006. 90% of the foetuses with Down's syndrome are detected prenatally. Denmark is one of the first countries in the world in which risk assessment for Down's syndrome has been successfully implemented at a national level.