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Biomedical subjects

B Petrikovsky

Publications and source records attributed to B Petrikovsky.

36 records · Page 2Linked to original sources
PubMed1994

Prenatal evaluation and in utero platelet transfusion for thrombocytopenia absent radii syndrome.

A fetus with absent radii in both forearms was discovered on routine ultrasound examination performed at 18 weeks of pregnancy. No other significant abnormalities were found, and no signs of haemorrhage were detected. Serial ultrasound examinations revealed no evidence of fetal internal bleeding. At 37 weeks of pregnancy, a CBC obtained by cordocentesis under ultrasound guidance confirmed the diagnosis of thrombocytopenia absent radii (TAR) syndrome. Apheresis platelets were transfused into the umbilical vein to correct the thrombocytopenia and was followed by an uncomplicated delivery. No bleeding was encountered during the remainder of the baby's neonatal course. We conclude that TAR syndrome can be readily identified prenatally on sonogram, and if severe thrombocytopenia is confirmed by cordocentesis, platelets should be transfused to diminish the risk of serious internal bleeding during and immediately after delivery.

Adult↗
PubMed1993

Prenatal diagnosis and obstetric management of Larsen syndrome.

BACKGROUND: Larsen syndrome is a disease of generalized defect in collagen formation including multiple disorders of the joints and cardiac anomalies. A review of the literature revealed no previous reported cases in pregnancy. CASE: A 29-year-old woman with known Larsen syndrome thought to be of the autosomal recessive type presented in pregnancy; second-trimester ultrasound suggested fetal involvement with Larsen syndrome. The patient was followed with serial ultrasounds, and she had pediatric and anesthesiologic consultations. She was delivered by cesarean of a female infant whose neck was immediately stabilized. The infant was then taken to the neonatal intensive care unit, where a diagnosis of Larsen syndrome was confirmed. CONCLUSIONS: Larsen syndrome, which may be diagnosed prenatally, is a rare and unique condition that requires multidisciplinary care. Obstetric management must take into account the increased anesthetic and surgical risks to the mother and the risk of fetal injury including cervical spine instability. The genetics of Larsen syndrome are also discussed.

Adult↗
PubMed1989

Gynecologic screening examinations: does the obstetrician-gynecologist's spouse comply?

The practicing obstetrician-gynecologist has certainly moved toward more active teaching and encouragement of preventive medical measures during the past decade. The purpose of this study was to determine how these measures espoused by the practitioner are applied in the physician's family setting. To accomplish this, 5000 questionnaires were sent to actively practicing obstetrician-gynecologists. Questions pertained to health habits as well as social and demographic issues. The results revealed that preventive medical practices, which have a high impact on morbidity and mortality, were not practiced to a significant degree by the spouses of obstetrician-gynecologists. Approximately 17% of the spouses did not have yearly Papanicolaou smears. Women older than 55 years of age were less likely to have this screening test than their younger cohorts. Only 65% perform breast self-examination, and 36% did not have screening mammography performed when recommended. In the postmenopausal group, 57% of the spouses did not receive estrogen replacement therapy, whereas 32% had both estrogen- and progesterone replacement therapy and 11% took estrogen alone. Contraceptive measures used by respondents indicated essentially equal distribution among methods available. The majority of the physicians who responded indicated they did not smoke (84%), did not use illegal drugs (99%), and used alcohol occasionally or not at all (71%).

Adult↗
PubMed1988

Electronic fetal heart rate monitoring during cesarean section.

Fetal heart rate (FHR) response to cesarean section was studied in 65 patients. Induction of anesthesia, skin, fascial, peritoneal and bladder flap incisions were not associated with a change in FHR. Abdominal preparation was associated with FHR decelerations in 15% of cases. Myometrial incision was followed by FHR deceleration in 11% of cases. No correlation between the incision/delivery (I-D) interval and FHR changes was seen.

Anesthesia, Epidural↗
PubMed1986

Intrapartum hysteroscopy.

A new method of visualization of fetus, uterus, placenta, umbilical cord and amniotic fluid is presented. A flexible endoscope was inserted into the uterine cavity after spontaneous or artificial rupture of the membranes via the vaginal route in 85 patients. Endoscopy could be beneficial for precise determination of the nature and type of umbilical cord and placental pathology, signs of fetal dysmaturity, the presence of meconium and evaluation of the integrity of a uterine scar. Intrapartum hysteroscopy could be especially helpful for patients with no prenatal care who appear in labour with incomplete histories. The method is proven to be safe for both the mother and the neonate.

Adult↗
PubMedDate not supplied

Clinical significance of echogenic foci in fetal lungs.

PURPOSE: We reviewed our experience with echogenic foci in fetal lungs. METHODS: During the period January 1991 through December 1995, 16,292 patients underwent comprehensive ultrasound examinations between 16 and 42 weeks of pregnancy. Echogenic foci in the lungs were identified in 8 fetuses. All 8 underwent karyotyping, fetal echocardiography, screening for infectious agents, and follow-up sonography. The neonatal outcome was obtained in each case. RESULTS: The 5 fetuses in whom echogenic foci in the lungs were the only abnormal finding all had normal outcomes. One fetus had echogenic foci identified in 1 lung and the abdomen. This fetus tested positive for cytomegalovirus, and the pregnancy was terminated. Two fetuses with echogenic foci in the lungs had associated anomalies: 1 had an omphalocele, and the other had cerebral ventriculomegaly. Both of these pregnancies were terminated. CONCLUSIONS: In our series, isolated echogenic pulmonary foci were rare findings that carried a good prognosis. When echogenic foci in the lungs are identified, careful evaluation for associated abnormalities is warranted.

Female↗
PubMedDate not supplied

Fetal heart rate monitoring casebook. Checkmark fetal heart rate pattern and normal neonatal outcome.

BACKGROUND: A checkmark pattern of the fetal heart rate (FHR) had been seen in association with hypoxia in human and animal fetuses. CASE: We report a checkmark pattern in a fetus of a 26-year-old primigravida who underwent induction of labor at term. Scalp pH was 7.32. Comprehensive ultrasound examination revealed normal results. The neonate was born in satisfactory condition. Apgar scores were 7 and 10 at 1 at 5 minutes of life, respectively. CONCLUSION: Checkmark FHR pattern may be a benign finding; however, if it is detected, it should be closely monitored.

Adult↗
PubMedDate not supplied

Single-needle insertion technique for thoracocentesis for bilateral pleural effusions.

A 28-week fetus with hydrops and bilateral pleural effusions underwent drainage of both pleural spaces via a single-needle supradiaphragmatic insertion technique. The traditional approach was not feasible due to a persistently unfavorable fetal position. The dependent pleural effusion was drained by a needle which coursed through the nondependent pleural effusion. The needle traversed the midline pleura through an avascular plane. Thereafter the needle was withdrawn into nondependent pleural effusion which was drained. Both lungs expanded with favorable neonatal outcome.

Adult↗
PubMedDate not supplied

Natural history of hydrops resolution in fetuses with tachyarrhythmias diagnosed and treated in utero.

Fetal tachyarrhythmias are life-threatening conditions for the fetus. Long-standing tachyarrhythmias often lead to fetal cardiac failure, hydrops and death. Normalization of the fetal cardiac rhythm leads to resolution of fetal hydrops. This report describes the sequence and timing of fetal hydrops resolution after successful therapy. Fetuses with a persistent heart rate over 180 beats/min with a 1:1 atrioventricular conduction (on M mode) were defined as having supraventricular tachycardia. Fetal hydrops was diagnosed if the following signs were seen: pleural and/or pericardial effusion and/or ascites or/and skin edema. Five fetuses with sustained fetal tachycardia and hydrops who converted to normal rhythm with antiarrhythmic agents treated at Stony Brook University Hospital and North Shore University Hospital between 1988 and 1995 are included. Resolution of hydrops required from 4 to 6 weeks and occurred in the following sequence: diminution of ascites; pleural and pericardial effusions, and disappearance of skin and scalp edema. Minimal signs of fluid retention (small ascites, mild hydrocele) remained in studied fetuses until term. Understanding the natural history of hydrops in cases of fetal tachyarrythmias will allow for accurate patient counseling pertaining to the expected timing of hydrops resolution after successful therapy.

Digoxin↗
PubMedDate not supplied

Cordocentesis using the combined technique; needle guide-assisted and free-hand.

Two hundred and sixteen diagnostic cordocenteses were performed using the following technique: A guide was used to deliver the distal end of the needle to the immediate vicinity of the umbilical cord, after which the needle was released from the guide and a free-hand technique was used to enter the umbilical cord. The vessel punctured was identified by its sonographic appearance and flow direction using color Doppler technology. All procedure-related losses which occurred within 2 weeks were analyzed. The gestational age at the time of cordocentesis ranged from 18 to 42 weeks. Most punctures (62%) were performed at the placental insertion of the umbilical cord. In 32% of fetuses the free-floating loop was sampled and in 6% the puncture was performed at the site of cord entry into the fetus. Two fetuses died shortly after cordocentesis. One death occurred at 28 weeks in a fetus with severe cytomegalovirus infection. The other death was due to premature rupture of the membranes after the procedure in a very premature fetus. The overall fetal loss rate was 0.93%. In conclusion, the combination of the two cordocentesis techniques appears safe and highly successful in obtaining fetal blood samples.

Cordocentesis↗