Search PubMed⌕ Search

Biomedical subjects

C S Levi

Publications and source records attributed to C S Levi.

17 recordsLinked to original sources
PubMed1992

First-trimester umbilical cord cysts.

Cystic masses of the umbilical cord have been detected in the 2nd and 3rd trimesters of pregnancy in association with fetal abdominal wall defects and chromosomal anomalies. With high-resolution endovaginal ultrasound (US), umbilical cord cysts can be visualized during the 1st trimester. Their origin and significance must be considered for proper obstetric management. The authors report eight cases in which cystic masses of the umbilical cord were detected during US examinations performed at 8-9 weeks menstrual age. In the five cases followed to term, both the infant and the umbilical cord were found to be normal at physical examination. Sonographically, all cysts appeared to be eccentric in relation to the umbilical cord, and, although all were closer to the fetus, the cysts were clearly extraembryonic. Cyst size was 2.0-7.5 mm (mean, 5.2 mm). Seven cysts resolved by 12 weeks menstrual age. The incidence of cysts in patients who underwent US at the authors' institution between 8 and 12 weeks menstrual age was 0.4%; the true frequency is unknown without routine 1st-trimester scanning of all patients.

Cysts↗
PubMed1992

Yolk sac diameter and shape at endovaginal US: predictors of pregnancy outcome in the first trimester.

Four hundred eighty-six consecutive women who underwent endovaginal sonography when their fetuses were less than 10 weeks menstrual age (MA) were evaluated to establish the normal size and shape of the secondary yolk sac (YS) and to assess the value of YS measurement in predicting pregnancy outcome in the first trimester. A YS diameter more than two standard deviations (SDs) above the mean when compared with the mean gestational sac diameter allowed prediction of an abnormal pregnancy outcome with a sensitivity of 15.6%, a specificity of 97.4%, and a positive predictive value of 60.0%. A YS diameter more than two SDs below the mean allowed prediction of an abnormal outcome with a sensitivity of 15.6%, a specificity of 95.3%, and a positive predictive value of 44.4%. No pregnancy with a normal outcome had a YS diameter of greater than 5.6 mm at less than 10 weeks MA. In six patients, the YS diameter was greater than 5.6 mm. All six had an abnormal outcome. Of seven patients with abnormal YS shape at initial sonography, three had abnormal YS shape at follow-up examinations. All three had an abnormal outcome.

Abortion, Spontaneous↗
PubMed1992

Endovaginal and translabial ultrasound in pregnancy.

Endovaginal sonography provides earlier and enhanced visualization of the gestational sac and its contents than does transvesical sonography. This paper discusses the role of endovaginal sonography in common first trimester diagnostic problems, including pregnancy dating, first trimester pregnancy loss, ectopic pregnancy, and early diagnosis of fetal anomalies, and reviews the use of endovaginal color flow Doppler in the diagnosis of ectopic pregnancy. A brief discussion of the role of endovaginal and translabial sonography in the second and third trimesters is included.

Female↗
PubMed1991

Characterization of subendometrial myometrial contractions throughout the menstrual cycle in normal fertile women.

The objective was to study the characteristics of ultrasonographically detected subendometrial myometrial contractions. The contractions were evaluated by 328 ultrasound scans throughout the menstrual cycle. Reproducibility of these findings were studied in consecutive cycles. Eighteen healthy ovulatory volunteers with proven fertility were evaluated for at least one complete menstrual cycle in the follicular, periovulatory, and luteal phases. Multiple cycles were studied in 10 volunteers. The results showed that the contractions increase in frequency, amplitude, and percentage toward the fundus throughout the follicular and periovulatory phases. The pattern is essentially reversed in the luteal phase. There is reproducibility of these patterns from cycle to cycle. We conclude that there is a definite identifiable pattern of subendometrial myometrial contractility that varies with the phases of the normal menstrual cycle and recurs in a similar fashion from cycle to cycle.

Adult↗
PubMed1991

Endovaginal sonographic diagnosis of ectopic twin gestation.

Endovaginal sonography has permitted earlier diagnosis of ectopic pregnancy. Twin ectopic pregnancy is rare. Until now, antenatal diagnosis of twin ectopic pregnancy using endovaginal sonography had not been reported. Three cases of twin ectopic pregnancy diagnosed via the intracavitary probe are presented.

Adult↗
PubMed1990

Contractions of the inner third of the myometrium.

Forty-six consecutive endovaginal ultrasound examinations were screened for the presence of myometrial contractions. The study group contained pregnant women up to 10 weeks' menstrual age, nonpregnant, and postmenopausal women. Rhythmic myometrial contractions of the inner myometrial third not previously reported were seen in 35 studies in pregnant, nonpregnant, and postmenopausal women. The contractions involved the inner third of the myometrium in all but two cases. In these two cases, all three muscular layers were involved. The majority of women showed retrograde contractions, with the contraction wave moving from the cervix to the fundus. In menstruating women and one case of abortion, the contractions were antegrade. It is our speculation that these retrograde contractions of the inner myometrial third may be important in sperm transport and for the conservation of early pregnancies within the uterine cavity.

Adult↗
PubMed1990

Endovaginal US: demonstration of cardiac activity in embryos of less than 5.0 mm in crown-rump length.

The authors reviewed the endovaginal ultrasonographic (US) findings for 96 patients with embryos with crown-rump lengths of less than 5.0 mm. Of the 71 patients with adequate follow-up, initial endovaginal US demonstrated cardiac activity in 46 embryos and no cardiac activity in 25. Initial endovaginal US failed to demonstrate cardiac activity in five of 40 normal embryos, three with crown-rump lengths of less than 2.0 mm and two, between 2.0 and 3.9 mm. Endovaginal US identified cardiac activity in all 12 normal embryos with crown-rump lengths of 4.0-4.9 mm. The presence of cardiac activity was associated with a 24% risk of spontaneous abortion. In embryos between 2.0 and 4.9 mm in crown-rump length, absent cardiac activity was associated with a 91% risk of abortion. All 17 patients with vaginal bleeding and embryos demonstrating no cardiac activity subsequently aborted. The embryonic yolk sac was absent in 35% of patients who subsequently aborted. Variation outside of the 95% confidence limits of the mean for crown-rump length compared with mean gestational sac diameter and yolk sac diameter was also helpful in predicting an abnormal outcome. Nonvisualization of cardiac activity at endovaginal US in embryos less than 4.0 mm in crown-rump length may be normal and warrants follow-up US examination.

Abortion, Spontaneous↗
PubMed1990

Ultrasound in the first trimester of pregnancy.

High-resolution sonography, including transvesical and endovaginal techniques, has resulted in enhanced visualization of embryonic and extraembryonic structures. With endovaginal sonography, the gestational sac may be seen within the decidua at about 4.5 weeks menstrual age. The yolk sac is the first structure to be seen within the gestational sac, and confirms the presence of a gestational sac rather than a decidual cast. The embryo is identified by endovaginal sonography early in the 6th week, and cardiac activity is routinely identified by a crown-rump length of 3 to 5 mm. On endovaginal sonography, absent cardiac activity in an embryo having a crown-rump length of greater than 3 to 5 mm indicates embryonic death. With endovaginal scanning, a gestational sac of greater than 8 mm without a yolk sac, or greater than 16 mm without an embryo, also indicates a nonviable pregnancy. Routine sonography primarily to assess the menstrual age should be performed in the second trimester, when added clinically relevant information may be obtained. Although it is possible to diagnose some anomalies in the first trimester, most remain second trimester sonographic diagnoses.

Congenital Abnormalities↗
PubMed1988

Early diagnosis of nonviable pregnancy with endovaginal US.

The mean diameter of the gestation sac and the presence or absence of a yolk sac or embryo and/or cardiac pulsations on endovaginal ultrasound (US) images were correlated with normal and abnormal outcomes of pregnancy. Sixty-two patients who were less than 10 weeks pregnant (menstrual age) underwent endovaginal US. In 59 patients with gestation sacs greater than or equal to 8 mm, the absence of a yolk sac predicted a nonviable pregnancy with a sensitivity of 67% and a specificity of 100%. In 35 patients with gestation sacs greater than or equal to 16 mm, the absence of an embryo predicted a nonviable pregnancy with a sensitivity of 50% and a specificity of 100%. When the absence of cardiac pulsations was added to the latter group of patients, the sensitivity was 100% and the specificity was 100%. The combination of these criteria (gestation sac size; demonstration of yolk sac, embryo and/or cardiac pulsations) enabled the early (less than 10 weeks menstrual age) diagnosis of a nonviable pregnancy with endovaginal US.

Amnion↗
PubMed1988

Suspected ectopic pregnancy: endovaginal and transvesical US.

Until the advent of endovaginal ultrasonography (US), transvesical US was the only US technique availab le for evaluation of patients with suspected ectopic gestation. A study was undertaken to assess the predictive ability of transvesical and endovaginal US and determine whether endovaginal US could be used alone. Fifty-three patients who had a positive pregnancy test finding and who were at risk for ectopic pregnancy were examined with both endovaginal and transvesical US. Twenty-nine were examined retrospectively and 24 were examined prospectively. Standard sonographic criteria were used to differentiate between intrauterine pregnancy and ectopic gestation. The clinical or pathologic diagnosis was ectopic pregnancy in 18 patients (34%), normal intrauterine pregnancy in 19 (36%), and abnormal intrauterine pregnancy in 16 (30%). Endovaginal US increased the sensitivity of detecting a live ectopic pregnancy (from 6% to 17%). Endovaginal US, by allowing early diagnosis of intrauterine pregnancy, significantly increased the diagnostic accuracy for ectopic pregnancy (from 60% to 83%). Endovaginal US provided significant additional information in women referred for sonography with a suspected ectopic gestation. On the basis of these findings it is concluded that endovaginal US can be used alone in the majority of women with suspected ectopic gestation.

Female↗
PubMed1987

The value of combined pulsed-Doppler and high-resolution real-time sonography of the extracranial carotid system.

Duplex carotid sonography (DCS) (high-resolution real-time with combined pulsed Doppler) was performed in 374 symptomatic patients. Biplane angiographic correlation was available in 172 extracranial carotid systems. Degree of stenosis was estimated by the Doppler spectrum and by real-time appearances and categorized as: normal; less than 10% diameter reduction; 10-49% diameter reduction; 50-99% diameter reduction; or occlusion. The overall accuracy of sonography was 88%. Normal arteries were identified with a specificity of 96% and a positive predictive value of 97%. Hemodynamically, significant lesions were differentiated from less severe disease with an accuracy of 95%, a positive predictive value of 87%, and a negative predictive value of 100%. Occlusions were identified with a sensitivity of 80% and a positive value of 91%. Duplex sonography is an accurate, noninvasive method of evaluating the extracranial carotid system.

Angiography↗
PubMed1982

The abnormal fetus.

Explore the source record for details and available documents.

Abdominal Muscles↗