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The Effects of Radiation in Vaginal Ultrasonography on the Human Early Embryos

Author: WuYanLing
Tutor: LengWeiChun
School: Jilin University
Course: Obstetrics and Gynaecology
Keywords: Vaginal Ultrasonography Embryo Villus Ultrastructure
CLC: R715
Type: Master's thesis
Year: 2008
Downloads: 116
Quote: 1
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Abstract


As simple, practical and harmless, the ultrasonography has already become one of the most used imageology diagnosis approaches since it had been put into clinical use from 1942.At present, the ultrasound diagnosis technology is considered as an indispensable routine diagnosing and treating approach in perinatology. It is widely applied to the early pregnancy diagnosis, ovulation monitoring, taking eggs and killing embryos in assisted reproductive technology, prenatal care, and ectopic pregnancy identification. Because the vagina ultrasonic can inspect embryo organs in a nearer distance, full bladder is not needed. Furthermore, it can diagnose the pregnancy in an earlier time and prevent patients from waiting for a medical examination.Vaginal ultrasonography technique is popular among doctors and patients. It is used more frequently and is prone to replacing abdominal ultrasonography in diagnosing an early pregnancy or identifying an ectopic pregnancy. Along with the requirement for increasing ultrasound diagnosis accuracies in clinical work, the ultrasonography technology is improved.At the same time, the energy of the ultrasonic radiation increases gradually. Thus, the ultrasonic security to embryos is remarkably highlighted. In the vulnerable embryo stage, the embryo may be hurt in vaginal ultrasonography with the observation under high-frequency vaginal ultrasonic in a very near distance.Therefore, the extensive researches to this technology are very essential. During these years, the researches never stop. For reasons of laws and medical ethics, the foreign countries lag behind China in such researches. Although some researchers have reached the molecular level, and additionally the influence of ultrasound on the cell apoptosis in different organs has been reported in succession in China, due to research costs, sampling difficulty, and inter-discipline involvement, these results are obtained through animal experiments.The objective of the research: To study the effects of ultrasonic wave on the human embryo. Observe the time and style of the pathological changes in the human embryo villus in the exposure to the high-frequency ultrasonic waves at different time with the vaginal ultrasonography.Method: Among the pregnant women who have visited Shenzhen Shekou People’s Hospital from August 2007 to May 2008 for artificial abortion to terminate their pregnancies, random select patients who meet the following requirements:(1) Who were 20 to 35 years old.(2) Whose menstruation ceased for 38 to 60 days.(3) Who had regular progestational menstrual cycle; whose last menstrual period was accurate and no bleeding in pregnant period.(4) Who had no medicine in the gestation period, and no contraceptive for six months before pregnancy.(5) Who had no oaf childbirth, natural abortion, or hereditary disease.(6) the pregnant woman and her spouse were healthy; the pregnant woman had no-virus infection and hadn’t contact the poison irradioactive rays.(7) Who were not addicted to tobacco or alcohol.Then, divide them into three groups in diagnostic order:Group A: The reference group (routine abdominal ultrasonography);Group B: in the exposure to the vagina ultrasonic for 5 minutes;Group C: in the exposure to the vagina ultrasonic for 10 minutes. The patients were told about the duration of the transvaginal ultrasonography,the object and the meaning of the study. After the patients agreed with these,they emptied the urinary bladder and laid flat on the examination couch. By using the transvaginal ultrasound of 7.5 MHz, the gestation sac is found and irradiated directly for 5 or 10 minutes. At the same time, we measured the gestation sac and found out the fetal heart and embryonic shoot, and then wrote down. After exposing to the vagina ultrasonic for 24 to 32 hours, we performed the artificial abortion and took the villi, cleaned the villi with normal saline and put them in 2.5% glutaraldehyde solution within 1 minute. Then, kept them in the refrigerator at 3℃and sent them to Zhongshan University Electron Microscope Department for an observation with the electron microscope on the changes in the ultrastructure of the embryo villi.The results show that: The villi’s ultrastructure of the reference group (Group A) is normal. The basal membrane of all the samples has no change. The ultrastructure of Group B which exposed for 5 minutes changes little. There are two out of 12 have the cell membrane burst in the syncytiotrophoblast and the cytotrophoblast, and the cell organ is swelling; swelling occurs in one sample’s rough endoplasmic reticulum of the mesenchymal cell; the glycogen increases in partial cells. The ultrastructures of the other 10 samples are normal. All villus basement membrane are connective without any visible change. Resulted from the gestational sac of the early pregnancy that has been continuously exposed to transvaginal ultrasound for about 10 minutes, the following changes in villi ultrastructure of the embryo are as follows:The microvilli are broken off and disorganized, or even vanishing completely; The nucleus swelling occurs in the syncytiotropho- blast;The endochylema vacuolizes;The rough endoplasmic reticulum expands;The mitochondria is swelling and a part of it has membranolysis;The cellular swelling occurs in the cytotrophoblast;The endochylema vacuolizes;The organelle expands;The glycogen increases;The rough endoplasmic reticulum swells in the mesenchymal cell;The membranolysis break off; The endochylema is extending;The organelle outleaks.Discussion: Now it is thought that the biological effect of the ultrasound wave lies in the thermal effect, cavity function and stress mechanism. The cavity function is most important to the diagnostic ultrasound. Cavity can produce a lot of free radicals, especially in liquid environment such as amniotic fluid and blood plasma. Ultrasound can activate the cavitation nucleus in the cell to activate the cavitation, and produces massive free radicals partially. Superoxide dismutase which is an important member of the antioxidase system can eliminate the free radicals and protect the organism. The free radicals are accumulated in a great deal due to physical and chemical factors. This causes that the SOD activeness is reduced, and its ability of eliminating free radicals is undermined. Bulk deposition of free radicals may cause the lipid peroxidation of polyunsaturated fatty acid in the cell membrane. The lipid peroxidation, however, increases the cell permeability, causes mitochondria expansion, and makes the enzyme lose its activity. These lead the cell to multiple damages.In this research, the control group (Group A) changes little. The pathological change in the ultrastructure happens on two out of the 12 samples whose villi are exposed to the transvaginal ultrasound for 5 minutes. The ultrastructure of the villi in Group C for 10 minutes changes obviously. This shows that, with the certain acoustic output intensity, the longer the villi are exposed to the transvaginal ultrasound, the severer the damage will be.This is because that along with the time lapses, the SOD activeness drops, and its ability to eliminate the oxygen free radical is undermined. The lipid peroxidation is strengthened, and the metabolite increases, which result in the cell change. The mitochondria plays a main role in a cell during the biological oxidation. The increasing free radicals can cause a series of changes, such as the mitochondrial crista and lead the mitochondria swelling.Therefore, the ultrasonic radiation draws the people’s attention because its latent harm threatens the human embryo. Before the public radiation threshold and borderline time are determined, we should hold active and positive attitude to use the ultrasonography. We must insist to the principle to“obtain the essential diagnostic message within shortest radiation time and with the smallest radiation intensity”. Further studies are required on the radiation threshold and the borderline time of which the vaginal ultrasonic radiation causes the change in the humanity early embryo ultrastructure, as well as the study on the recoverability of the affect of the ultrasonic radiation on the human embryo.Conclusion: The vaginal ultrasonic radiation may affect the ultrastructure of human early pregnancy embryos. Its pathological change mainly occurs in the synthesis trophoderm, and then the cytotrophoblast. The mesenchyma changes a little. The basement membrane basically changes little. This kind of influence is related to the duration of exposure. The longer exposure lasts, the more obvious the changes will be. The routine abdominal ultrasound’s irradiation changes little. It is not found the obvious pathological change in the ultrastructure of the villi which exposed to the transvaginal ultrasound for 5 min. The ultrastructure of the villi which exposed to the transvaginal ultrasound for 10 min changes obviously. The vaginal ultrasonography for the early pregnant should be controlled in 5 min, less than 10 min.

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CLC: > Medicine, health > Obstetrics and Gynaecology > Clinical eugenics
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