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Biomedical subjects

C Nimrod

Publications and source records attributed to C Nimrod.

36 records · Page 2Linked to original sources
PubMed1988

Pulmonary hypoplasia testing in clinical obstetrics.

An ultrasound-based diagnostic test for predicting pulmonary hypoplasia antenatally by measurements of fetal chest circumference was applied prospectively to 45 patients at risk for developing this disorder. The outcome for the newborn infant and the autopsy findings were correlated with the antenatal prediction. The results of this test demonstrated a sensitivity and a specificity of 88% and 96%, respectively. The application of this test to clinical practice is recommended.

Amniotic Fluid↗
PubMed1988

Evaluation of fetal cardiac dysrhythmias with two-dimensional, M-mode, and pulsed Doppler ultrasonography.

Forty-three patients with fetal cardiac dysrhythmia were referred to a tertiary ultrasound department for further evaluation. The patients were subdivided according to the type of dysrhythmia diagnosed. All patients with irregular fetal heart rate had a good perinatal outcome. Of the six patients with fetal tachycardia, two required in utero therapy with maternal digoxin, and one of these fetuses had a cardiac tumor. The eleven patients with fetal bradycardia had the worst perinatal outcome, with four deaths occurring. The results suggest that all patients with fetal tachycardia or bradycardia should have a complete fetal cardiac assessment in a center experienced with the management of such cases.

Algorithms↗
PubMed1988

Birth patterns: are the Chinese in Guangzhou City different?

Diurnal birth patterns in the City of Guangzhou, China and the City of Calgary in Canada were compared. Chinese data were abstracted from the labor room log book of one large general hospital located in the Hai Zhu district of Guangzhou. Calgary birth data were abstracted from birth notification forms submitted to Calgary Health Services. Information included day of birth, time of delivery, type of delivery and parity. Calgary births are concentrated on Tuesdays to Fridays whereas in Guangzhou weekly patterns varied tremendously according to whether it was assisted or unassisted. Calgary births are below average at night and during evening shift. The time of birth in Guangzhou varied substantially with above average rates for non-assisted births noted at 0800-2400 h, and above average rates for assisted births noted at 0800-1700 h. Differences in hour of birth appeared to be related to obstetric intervention practices. Knowledge of birthing patterns are useful for effective hospital management.

Canada↗
PubMed1988

Atrial natriuretic peptide production in association with nonimmune fetal hydrops.

The presence and elevation of atrial natriuretic peptide in fetuses has not previously been demonstrated. This study of right atrial pacing in fetal lambs demonstrated a threefold to fourfold increase in atrial natriuretic peptide during the production of fetal hydrops. Its rate of return to a normal level paralleled the clearance of fetal hydrops. Its possible role in fetal cardiovascular hemodynamics is discussed.

Animals↗
PubMed1987

Clinical utility of multiple-dose administration of prostaglandin E2 gel.

An open-label study was undertaken to assess the clinical impact of multiple doses of intracervical prostaglandin E2 (0.5 mg) gel administered at 6-hour intervals. Fifty women with low Bishop scores requiring induction of labor were recruited. The prestudy mean Bishop score was 2.3 +/- 1.1 and changed significantly with one (p less than 0.001), two (p less than 0.001), and three (p less than 0.002) doses. The mean gestational age of patients receiving three doses was significantly less than that of patients receiving one dose, (38.5 versus 40.1 weeks, p less than 0.005). Prostaglandin E2 gel induced labor in 56% of patients, but 14% required subsequent oxytocin (Syntocinon) augmentation. Cesarean section was performed in 6% of patients. No deleterious fetal, neonatal, or maternal effects occurred.

Adult↗
PubMed1987

Doppler ultrasound prediction of fetal outcome in twin pregnancies.

The usefulness of pulsed Doppler ultrasound in predicting twin pregnancies destined for unsatisfactory outcomes was examined in 30 twin pregnancies. Fetal flow velocity waveform analysis (systolic/diastolic ratio and pulsatility index) and quantitative analysis in the descending aorta and umbilical artery demonstrated good sensitivity and specificity when compared with biparietal diameter and abdominal circumference measurements. This technique shows some promise as a useful adjunct in the management of twin pregnancies.

Aorta, Thoracic↗
PubMed1987

Ultrasound evaluation of tachycardia-induced hydrops in the fetal lamb.

Nonimmune hydrops was induced in six fetal lambs at 120 days' gestation by right atrial pacing at 300 beats/min. Biochemical, hemodynamic, and Doppler parameters were observed and monitored by real-time ultrasound during the creation (18 to 42 hours) and resolution of hydrops. The significant changes seen were hypoproteinemia (34.3 to 29.0 mg/100 ml), venous hypertension (24.6 to 31.3 mm Hg), decreases in thoracic aorta flow, and decreases in systolic/diastolic ratios in the aorta and umbilical artery. These changes were reversed with the discontinuation of pacing and the resolution of fetal hydrops.

Animals↗
PubMed1986

Ultrasound prediction of pulmonary hypoplasia.

Normograms for ultrasound-measured fetal chest and heart circumferences were constructed from 83 normal pregnancies of 24 to 39 weeks' duration. Of six cases at risk for pulmonary hypoplasia, all of whom ultimately proved to have the condition, four fell below the fifth percentile for chest circumferences. Both cases in which the chest circumference was within the normal range had pleural effusions.

Cross-Sectional Studies↗
PubMed1985

Intrauterine hydrocephalus and ventriculomegaly: associated anomalies and fetal outcome.

Advances in fetal diagnostic techniques have opened many areas to prenatal anatomical scrutiny. Intrauterine hydrocephalus and ventriculomegaly are conditions which are readily diagnosed. Fetal intervention has been undertaken in humans in order to minimize the craniofacial disfigurement and to maximize the growth potential of the brain. To justify such an approach, the significance of all anomalies should be recognized prior to treatment. The authors have reviewed 41 cases of hydrocephalus diagnosed in utero in order to define associated anomalies and patient outcome. 75% of our personal series and 72% of the reviewed literature cases had other anomalies of the central nervous system. Other system malformations, some of which proved fatal, were seen commonly. Prenatal diagnostic techniques did not always reveal these additional problems. The outcome of these pregnancies is not good. Approximately one third of these fetuses have survived to be treated postnatally and to be followed up clinically. Only 7.5% of this series were felt to have attained normal developmental milestones. The remainder of the survivors have various focal and/or global cerebral deficits.

Abnormalities, Multiple↗
PubMed1984

In utero evaluation of fetal cardiac structure: a preliminary report.

Fetal echocardiography as a tool for the prenatal diagnosis of cardiac structural abnormalities was utilized in 27 consecutive patients who were referred for evaluation. Four abnormalities were recognized prenatally and confirmed postnatally. A fifth was identified postnatally. The sensitivity and specificity of this diagnostic test were 80% and 100%, respectively. The utilization of this tool in a tertiary care setting by an adequately trained team has proved to be helpful and is recommended.

Echocardiography↗
PubMed1984

The effect of very prolonged membrane rupture on fetal development.

This retrospective study examined the effects of very prolonged membrane rupture of more than 1 week on the development of pulmonary hypoplasia and positional deformities in the infants of 100 consecutive women. A control group of infants who were matched for gestational age at delivery, sex, and time of delivery was identified. The results indicate that there was a statistically significant difference (p less than 0.001) in the occurrence of pulmonary hypoplasia and positional deformities. The greatest impact of prolonged membrane rupture on fetal development was seen in the patients in whom membrane rupture occurred prior to 26 weeks' gestation and the duration of rupture was more than 5 weeks.

Bone and Bones↗
PubMed1984

Pulmonary edema associated with isoxsuprine therapy.

A 0.5% incidence of pulmonary edema was observed when the records of 1,407 patients treated with parenteral isoxsuprine over a 7-year interval were reviewed. Drug infusion rates were within the normal range in the seven affected patients. Discontinuation of therapy, oxygenation, and the administration of diuretics with or without digoxin were successful in reversing the process in all cases. Anemia, multiple gestation, and excessive intravenous fluids were identified as possible risk factors.

Adult↗
PubMed1984

Cervical ripening and labor induction with intracervical triacetin base prostaglandin E2 gel: a placebo-controlled study.

A double-blind, randomized, placebo-controlled study was undertaken to evaluate the efficacy of a single-dose, shelf-stable preparation of prostaglandin E2 gel (PGE2) when used intracervically in patients with low Bishop scores. Two different preparations (0.5 and 0.25 mg) of PGE2 were used and a total of 45 patients were studied. Both preparations of PGE2 demonstrated a statistically significant increase in the spontaneous labor rate as compared with the placebo gel. Bishop scores were altered in all patients not proceeding to labor spontaneously, but the changes were most significant in the low- and high-dose groups. No significant deleterious affects were noted. The efficacy and safety of this new, sterile, and stable preparation makes it suitable for clinical use.

Apgar Score↗
PubMed1983

Effect of delivery method on outcomes in the very low-birth weight breech infant: is the improved survival related to cesarean section or other perinatal care maneuvers?

The perinatal mortality rate among very low-birth weight infants has been decreased by 20% during the last 4 years of the 1973 to 1980 period here reported. The concurrent increase in the cesarean section rate from 11.9% to 49.1% during the same time frames has been assumed to be responsible for the improved outcome. The changes were most marked in the extremely low-birth weight group (less than 1,000 gm). The survival rates and cesarean section rates were examined among infants of similar birth weight and gestational age in the vertex presentation, in the same time frames. A similar or greater reduction in mortality rate (from 85% to 45%) was noted in the very low-birth weight vertex infants, whereas the cesarean section rate remained minimally and not significantly increased (14.2% to 22.2%). The interpretation of this finding is by no means clear but must include the hypothesis that the increased cesarean section rate may be incidental and in no way related to the improved outcome. The most statistically significant determinants of outcome remain birth weight and gestational age strata, with no significant difference in outcomes when the extremely low-birth weight group is analyzed separately from the entire very low-birth weight group. As yet unidentified perinatal care practices, other than cesarean section, may be more likely to affect outcome in this high-risk group.

Birth Weight↗
PubMed1983

Pregnancy complications in type IV Ehlers-Danlos Syndrome.

Type IV Ehlers-Danlos syndrome (EDSIV), unlike other forms of EDS, appears to be associated with a high incidence of pregnancy complications. In a group of fourteen families 20 women with EDS IV were identified. The diagnosis was confirmed in at least 1 member of each family by in-vitro measurement of type III collagen production by dermal fibroblasts, and all affected subjects produced lower levels of the protein than controls. Of the 20 women identified, 10 had been pregnant, and 5 had died from pregnancy-related complications. The overall risk of death in each pregnancy in this group was 25%. The complications of pregnancy included rupture of bowel, aorta, vena cava, or uterus; vaginal laceration; and post-partum uterine haemorrhage. The severity and frequency of the complications in this type of EDS warrant careful counselling before pregnancy and care of all pregnant patients in a high-risk facility.

Adult↗
PubMedDate not supplied

Change in smoking prevalence among pregnant women 1982-93.

Maternal smoking is the most prevalent risk factor for low birthweight in Canada. This study compared the prevalence of maternal smoking before and during pregnancy from 1983 to 1992. Population-based surveys of 3,296 women during six months in 1983 and 7,940 women during 12 months in 1992 were conducted in Ottawa-Carleton using a self-administered questionnaire completed in the hospital postpartum period. The proportion of women smoking after the first trimester of pregnancy decreased from 28.5% in 1983 to 18.7% in 1992. This difference was due mainly to a reduction in the proportion of women who smoked before pregnancy (37.4% to 26.4%). Another factor was that more women stopped smoking early in pregnancy (23.9% to 29.2%). Gradients in levels of smoking by age, education, marital status and poverty level still exist; however, this is true for the general population. Programs to decrease smoking in pregnancy should continue to focus on reducing smoking among women in general and among those in the preconception and early stages of pregnancy in particular.

Adolescent↗