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Biomedical subjects

A C Cruz

Publications and source records attributed to A C Cruz.

At least 55 records · Page 3Linked to original sources
PubMed1983

Hydramnios: ultrasound diagnosis and its impact on perinatal management and pregnancy outcome.

Ultrasonographic technique allows for noninvasive quantification of amniotic fluid volume in pregnancy. A series of 12 pregnancies with ultrasonographically confirmed hydramnios is presented in detail. Following the diagnosis of hydramnios an intensive system-by-system evaluation of the fetal structures was performed. Developmental defects known to be associated with the production of hydramnios were detected in 83% of these pregnancies. Anomalies detected included abdominal wall defects, abnormalities of the central nervous system, pleural effusions, obstructions of the fetal gastrointestinal tract, and others. The early definition of hydramnios and the subsequent discovery of anomalies associated with increased amniotic fluid volume may lead to alteration in prenatal care, in intrapartum management, and in postdelivery resuscitative measures in these complicated pregnancies. In this series, despite early diagnosis of hydramnios and associated fetal developmental anomalies, complications of the pregnancies directly resultant from hydramnios resulted in a high perinatal mortality rate.

Congenital Abnormalities↗
PubMed1982

Changes in placental ultrasonic appearance. II. Pathologic significance of Grade III placental changes.

Changes in placental texture and structure on ultrasonic examination have been suggested as correlating to advancing fetal pulmonary maturity. The association of preterm appearance of Grade III changes in the placenta in the complicated pregnancy suggests that these changes are associated with a decrease in placental function and premature senescence of the placenta. Placentas were routinely graded on all obstetric examinations performed during a 1-year period of time. Those pregnancies in which Grade III changes in the placenta prior to term were reviewed. A high incidence (78%) of perinatal problems were found in association with preterm appearance of Grade III changes. Perinatal complications included maternal hypertensive disorders, intrauterine growth retardation, abruptio placentae, and fetal distress in labor. The high incidence of these disorders in preterm pregnancies with Grade III changes in the placenta suggests that the sonographic changes found reflect placental dysfunction or senescence rather than normal maturational development. The appearance of Grade III changes in the placenta in the preterm pregnancy is suggested as a predictive indicator of potential perinatal problems in late pregnancy.

Female↗
PubMed1982

Changes in placental ultrasonic appearance. I. Incidence of Grade III changes in the placenta in correlation to fetal pulmonary maturity.

Placental grading has been proposed as a substitute for amniotic fluid analysis for predicting fetal pulmonary maturity. The efficacy of placental grading was prospectively evaluated by grading the placenta at the time of 174 amniocentesis procedures done for determination of fetal pulmonary maturity. Grade III changes in the placenta were a rare finding that occurred in only 7% of the examinations performed. Placental grading proved to be insensitive in that it predicted pulmonary maturity in only 5% of pregnancies in which amniotic fluid analysis predicted a mature fetus. In addition, placental grading falsely predicted fetal pulmonary maturity in 42% of patients in whom Grade III placental changes were found. These findings suggest that the determination of Grade III changes in the placenta occurs too rarely to be of use in predicting fetal pulmonary maturity in the uncomplicated pregnancy. Incorrect prediction of pulmonary maturity by placental grading in the complicated pregnancy makes this test of little value in the management of high-risk pregnancy.

Amniocentesis↗
PubMed1982

Ultrasonic measurement of femur length as a predictor of fetal gestational age.

Ultrasonic determination of fetal femur length is useful as a parameter in the determination of fetal gestational age. One hundred thirty measurements were made in pregnancies at 14 to 36 weeks' gestation. The measurements were plotted against gestational age, and we found that a strong correlation exists between fetal femur length and fetal gestational age, with 95% confidence limits of plus or minus seven days. This ultrasound parameter of fetal age assessment should be added to the other methods available for accurate dating of pregnancy.

Female↗
PubMed1981

Cyclic variation in the adherence of group B streptococci to human vaginal epithelial cells.

Studies conducted on three normally menstruating women demonstrated a distinct cyclic variation in adherence of group B streptococcus type III to vaginal epithelial cells. This cyclic variation consisted of a gradual rise in adherence during the first half of the menstrual cycle, reaching a maximum on day 14, followed by a sharp decline to low levels of adherence that persisted through the second half of the cycle. These changes in adherence correlated directly with the variation in the pyknotic index of the vaginal epithelial cells, suggesting that hormonal factors played a role in adherence of group B streptococci to vaginal epithelium.

Adult↗
PubMed1980

Reproductive failure and cervical incompetence in women exposed to diethylstilbestrol.

Exposure to diethylstilbestrol in utero is recognized to be associated with a wide range of developmental abnormalities in the female genital tract, the most prominent being adenocarcinoma of the vagina. Recently anatomic anomalies have been discovered with increasing frequency. This case illustrates the association of exposure to diethylstilbestrol, cervical incompetence, and poor reproductive history, and stresses the importance of early evaluation.

Adult↗
PubMed1980

Evaluation of a continuous tissue pH monitor in the human fetus during labor.

Continuous tissue pH monitoring of the fetus was successfully conducted in 13 of 21 patients (61.9%) during labor. There was a significant correlation between the tissue pH and both the scalp capillary blood pH (r = 0.94, P less than 0.001) and the umbilical artery blood pH (r = 0.92, P less than 0.01). These findings confirm the accuracy of the tissue pH instrumentation in reflecting fetal acid-base status and support the potential usefulness of the instrumentation in perinatal medicine for continuous fetal acid-base monitoring.

Acid-Base Equilibrium↗
PubMed1979

Oxytocin challenge test results compared with simultaneously studied serum human placental lactogen and free estriol levels in high-risk pregnant women.

Three perinatal health indicators (serum human placental lactogen [hPL] levels, serum free estriol [E3] levels, and OCT) were simultaneously completed in 149 high-risk women who were more than 34 weeks pregnant. There was a significant correlation between the hPL and E3 results (r = 0.28, p less than 0.01). There was a 15.4% positive OCT result rate and the blood hormone values for the negative and positive OCT groups were compared. There was a significantly lower hPL value in the positive OCT group (4.7 +/- S.E.M. 0.4 vs. 6.2 +/- S.E.M. 0.2 micrograms/ml for positive and negative groups, respectively), whereas the free E3 levels were not different in these two OCT groups (14.8 +/- S.E.M. 1.5 vs. 16.3 +/- S.E.M. 0.7 ng/ml for positive and negative groups, respectively). The free E3 value did not help in predicting the OCT result as the low free E3 subgroup had the same frequency of positive OCT result as did the over-all group. There was a highly significant increase in the positive OCT results (42.9%) in women with a low hPL value (p less than 0.01). In those women with an hPL value of 6.0 microgram/ml or more there were only 8% positive OCT's. It is concluded that on hPL test at about 34 weeks of gestation could be used to screen pregnant women, and if the value were low (less than 4.0 microgram/ml) an OCT evaluation test would be indicated, for there is a very high frequency of positive results in that subgroup of women.

Estriol↗
PubMed1979

An evaluation of a continuous tissue pH monitor in the fetal and neonatal goat.

The validity of continuous tissue pH measurements was established in the fetal and neonatal goat model. Simultaneous determinations of tissue, arterial, and venous pH were done during alterations in acid-base status. A highly significant correlation was found between tissue and blood pH levels (r = 0.89, p less than 0.001). These data confirm the accuracy of the tissue pH instrumentation in predicting core blood pH status and support the potential usefulness of the instrumentation in perinatal medicine for continuous fetal acid-base monitoring.

Animals↗
PubMed1979

Assessment of fetal lung maturity: a comparison of the lecithin/sphingomyelin ratio and the tests of optical density at 400 and 650 nm.

Seventy-eight amniotic fluid samples were obtained by transabdominal amniocentesis and were analyzed for their L/S ratio and optical density at 400 and 650 nm. The L/S ratio was considered to be mature if the values were greater than 2.0. The optical density of the fluids decreased with prolonged refrigeration. With freshly centrifuged samples, the OD650 reading of greater than 0.15 gave the best correlation with the mature L/S ratio. There were 3.8% false positive results and 14.1% false negative results. The study confirms that the OD650 test on fresh amniotic fluid is a rapid and inexpensive way to determine fetal maturity. All samples with values of less than 0.15 must, however, also be tested for their L/S ratio since some of the infants with these values may also be mature.

Amniotic Fluid↗
PubMed1979

Intrauterine transfusion with continuous ultransonic assistance.

This paper describes a technic of intrauterine transfusion using continuous real time ultransonic assistance and discusses complications of intrauterine transfusion. The advantage of ultrasound-assisted intrauterine transfusion in reducing fetal injury and radiation exposure is emphasized.

Blood Transfusion, Intrauterine↗
PubMed1979

Factors influencing adherence of group B streptococci to human vaginal epithelial cells.

Factors affecting the adherence of group B streptococci to human vaginal epithelial cells in vitro were examined. Maximal adherence was achieved within 15 min of incubation of bacteria with epithelial cells. Adherence was temperature and pH dependent; maximal adherence occurred at 37 degrees C and pH 5.5. Killing of streptococci with ultraviolet light or penicillin did not affect adherence. Similarly, adherence was not altered by preincubating epithelial cells at 65 degrees C for 30 min. Thus neither bacterial nor epithelial cell viability appears to be a prerequisite for adherence. Preincubation of streptococci at 65 degrees C for 30 min resulted in a marked decrease in adherence, whereas preincubation of group B streptococci with neuraminidase was associated with a significant increase in adherence. The adherence of strains belonging to five different group B streptococcal serotypes was not altered by group-specific or type-specific rabbit antisera. These findings suggest that the site for adherence on the bacterial cell wall is heat sensitive and is marked by sialic acid, but is not related to either group-specific or type-specific antigens.

Adhesiveness↗
PubMed1979

Treatment of premature labor with ritodrine: a randomized controlled study.

Twenty-nine women with premature labor were randomly assigned to a ritodrine (N = 14) or placebo (N = 15) drug group. The 2 groups were of similar age, parity, weight, gestational age, and cervical change at the onset of treatment. They were treated sequentially with intravenous, intramuscular, and oral drugs and monitored carefully during therapy. There was a significant increase in both the maternal and fetal heart rates during ritodrine treatment, and also a significant decrease in maternal blood pressure. Ritodrine-treated women often complained of palpatations. There was no significant difference in the extension of pregnancy, birth weight, or infant survival for the ritodrine group. Although the 1-minute Apgar scores in the ritodrine group were higher, the 5-minute scores were similar in both groups.

Adult↗
PubMed1978

The acute effects of ritodrine infusion on maternal metabolism: measurements of levels of glucose, insulin, glucagon, triglycerides, cholesterol, placental lactogen and chorionic gonadotropin.

Twenty-nine women in premature labor were randomly assigned to a ritodrine (N = 14) or placebo (N = 15) treatment group. Thirteen serial blood samples were drawn during the first 12 hours of therapy by intravenous drug infusion and they were analyzed for a variety of metabolic substances. There was a significant increase in the blood glucose level in the ritodrine group after one hour and this persisted for the 12 hours of intravenous drug treatment. Plasma insulin levels similarly did not increase in the placebo but significantly rose in the ritodrine group by 30 minutes, peaked at 2 1/2 hours, and remained elevated throughout the infusion. There were no significant differences between levels of plasma glucagon, cholesterol triglyceride, human placental lactogen, or human chorionic gonadotropin in the two treatment groups. Ritodrine caused significant maternal and fetal tachycardia. Its use in women with carbohydrate abnormalities should be monitored carefully. The increased glucose levels may lead to an increased fetal weight.

Adult↗