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Biomedical subjects

A Ghidini

Publications and source records attributed to A Ghidini.

At least 109 records · Page 6Linked to original sources

Prenatal management of twin gestation. Experience with a new protocol.

We carried out a prospective cohort study to evaluate the usefulness of a specific protocol of prenatal management of twin pregnancy to decrease the incidence of prematurity in the population. The protocol particularly stressed the importance of early recognition of uterine contractile activity and early work leave (from 28 weeks' gestation). The outcome of 39 consecutive twin pregnancies that used the protocol over a five-year period was compared with the outcome of 76 twin pregnancies followed by private practitioners and delivered at our department. The two groups were comparable with respect to maternal age, parity, gestational age at diagnosis, socioeconomic level and educational level. The incidence of preterm delivery was significantly lower in the study group than in the control group. Even more significant was the difference in the incidence of severe prematurity (less than 34 weeks' gestation) between the two groups. The use of a protocol like ours, which does not include prolonged hospitalization, home bed rest or tocolytic treatment, is recommended.

Adult↗

Results of a preventive program for congenital toxoplasmosis.

All pregnant women followed during the period 1982-87 were screened for toxoplasmosis, and 35 patients had documented seroconversion or doubtful toxoplasmosis titers. One patient opted for pregnancy termination. The remaining were followed with a protocol that included serial ultrasound examinations and prophylactic antibiotic treatment of the mother and neonate. No fetal abnormalities related to congenital toxoplasmosis were found. All the infants had negative toxoplasmosis test titers at birth; at follow-up only one was found to have developed a subclinical infection, at 2 months of age. Our data suggest that antiparasitic treatment during pregnancy for those at risk for Toxoplasma infection may reduce the transmission rate.

Adult↗

Ureteropelvic junction obstruction in utero and ex utero.

Seventy cases of ureteropelvic junction obstruction, bilateral or unilateral, were followed prospectively throughout gestation and postnatally for an average of 2.3 years. Cases of ureteropelvic junction obstruction with a renal pelvis dilated less than 1 cm uniformly did well; those with a pyelectasis more than 2 cm, both bilateral and unilateral, had a favorable outcome in approximately three-quarters. Surprisingly, pelvis dilatation between 1-2 cm had a better outcome if bilateral than if unilateral.

Female↗

Pre-induction cervical ripening with prostaglandin E2 gel: intracervical versus intravaginal route.

The aim of our study was to evaluate the best method for cervical ripening before a classical induction with amniotomy and oxytocin. One hundred term pregnant patients who presented an unfavorable cervix and an indication for the induction of labor were assigned randomly to either 0.5 mg prostaglandin (PG) E2 gel intracervically (N = 52) or 3 mg PGE2 gel intravaginally (N = 48). The intravaginal gel had a greater effect on cervical ripening according to a modification of the Bishop score than did intracervical gel, but it had a higher incidence of side effects.

Administration, Intravaginal↗

Fetal intracranial calcifications.

In utero sonographic visualization of fetal intracranial calcifications during the second trimester is reported. Its diagnostic process, which included percutaneous umbilical cord blood sampling and fetal paracentesis, is described.

Brain Diseases↗

First trimester diagnosis of a partial mole with the combined use of ultrasound and chorionic villous sampling.

A patient with vaginal bleeding in the first trimester of pregnancy had a serum human chorionic gonadotropin (hCG) titer of 495,132 mlU/ml and an abdominal ultrasound examination revealed an intrauterine gestational sac without a fetal pole. Two and a half weeks later the hCG titer was 385,000 mlU/ml and a fetal pole was visualized. Transabdominal villous sampling was performed because of the suspicion of a partial mole. Histopathologic examination showed hydropic villi and chromosomal studies were consistent with triploidy. The diagnosis of partial mole in the first trimester of pregnancy was made and the pregnancy terminated.

Adult↗

Accuracy of ultrasound in the prenatal diagnosis of spinal anomalies.

This study was undertaken to determine the accuracy of sonographic examination in the prenatal diagnosis of neural tube defects. The study population consisted of 237 patients divided into three groups according to the indication for the sonographic examination. The overall sensitivity of sonography in the diagnosis of neural tube defects was 94.7%, and the specificity was 98.3%. A false positive diagnosis of spina bifida occurred in a fetus affected with ventriculomegaly, omphalocele, severe kyphosis and scoliosis. There were three false negative diagnoses of spina bifida.

Cross-Sectional Studies↗

Prenatal diagnosis of sirenomelia.

Prenatal sonographic findings of sirenomelia (or mermaid fetus) were retrospectively reviewed in eleven proven cases. Sonography showed oligohydramnios in all the cases, five (45%) of which had severe oligohydramnios that limited prenatal diagnosis by poor visibility. In five cases (45%), sirenomelia was correctly diagnosed by ultrasound; in the remainder, only bilateral renal agenesis was identified. All eleven fetuses had other associated malformations: congenital heart defects (4), skeletal deformities (10), and abdominal wall defects (4). Death resulted from termination of pregnancy in six cases and stillbirth in three cases. Two newborns died at 24 and 36 hours of neonatal life, respectively. We concluded that some cases of sirenomelia can be detected on prenatal sonograms by demonstration of a single lower extremity, oligohydramnios, and bilateral renal agenesis. Sirenomelia is a lethal condition and can be detectable in the second trimester of pregnancy, allowing for termination of pregnancy.

Amniotic Fluid↗

Antenatal sonographic findings of agenesis of corpus callosum.

Agenesis of the corpus callosum is a central nervous system anomaly that may be associated with other intracranial abnormalities. It is easily diagnosed in the postnatal period by computed tomographic scan and ultrasound. However, its prenatal sonographic diagnosis remains a challenge. This report will evaluate three cases of fetal agenesis of the corpus callosum, review the antenatal sonographic findings and postnatal outcomes, and provide criteria for the antenatal diagnosis.

Adult↗

Prenatal diagnosis of pentalogy of Cantrell.

Ten cases of prenatal diagnosis of Pentalogy of Cantrell are reported. A uniformly fatal outcome was found confirmed by a review of similar cases prenatally diagnosed by other authors. This is at variance with the data derived from the pediatric literature. Implications in obstetrical management and parental counseling are discussed.

Abnormalities, Multiple↗