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Biomedical subjects

D M Serr

Publications and source records attributed to D M Serr.

At least 91 records · Page 5Linked to original sources
PubMed1980

Prospective follow-up of patients with hydatidiform mole.

Of 74 Jewish patients with histologically confirmed hydatidiform mole (HM), 37 (50%) were referred to the hospital after the 15th week of pregnancy. In only 5.4% was HM the referral diagnosis. A correct diagnosis prior to uterine evacuation was made in only 29 (39.2%), and this was mainly when the uterus was normal or larger than expected for gestational age. The percentage with urinary human chorionic gonadotropin hemagglutination inhibition titers below 100,000 U/liter was significantly smaller in those with a smaller uterus as compared with those with a uterus of normal size or larger than expected. The incidence of persistent trophoblastic disease (PTD) following HM without the use of prophylactic chemotherapy was 12.2%. Patients with a large-for-date uterus had a greater potential for this outcome. All patients with PTD responded well to treatment, which consisted mainly of chemotherapy, and remained free of disease after therapy was completed.

Adolescent↗
PubMed1980

Uterine perforation during curettage: perforation rates and postperforation management.

Over a period of eight years, 13,344 consecutive patients underwent curettage in our hospital for various indications. Uterine perforation occurred in 22 (0.16%) of them. An additional seven patients were admitted with existing uterine perforation. The most common site of perforation was the uterine fundus and the instrument most often involved was a sharp curette. The perforation rates in curettage performed for postpartum hemorrhage and intrauterine adhesions were relatively high (5.1 and 1.8%, respectively); the rates in those for elective abortion and postmenopausal bleeding were intermediate (0.4 and 0.2%, respectively); and in those performed for other indications, the rate was very low (less than or equal to 0.06%). After uterine perforation occurred 15 patients (51.7%) were managed by observation only and the course was uneventful. In 10 patients (34.5%), exploratory laparotomy was performed; in three of them, no active bleeding organ injury was found. Judicious use of laparoscopy after uterine perforation allows proper selection of patients for further surgery.

Curettage↗
PubMed1979

Intra-amniotic thyroxine (T4) absorption by the premature human foetus.

We reported previously on the beneficial influence of intra-amniotic T4 injection in accelerating human foetal lung maturity. Twenty-four h after T4 (250 microgram) intra-amniotic injection, the mean cord serum T4 concentration in 13 premature newborns was 17 +/- 2.1 microgram/100 ml, while the T4 concentration in a matched group was only 11.6 +/- 0.9 microgram/100 ml: in 5 of the infants who received intra-amniotic thyroxine T4 was measured 12 h post-partum and rose from 16.1 +/- 1.8 to 24.3 +/- 2.6 microgram/100 ml. No change in maternal T4 concentration was observed. The mean cord serum T4 concentration in premature newborns delivered more than 3 days following T4 intra-amniotic injection, however, was not significantly different from that of the controls. These data suggest that T4 (250 microgram) injected intraamniotically is absorbed by the premature human foetus. Furthermore, the hyperthyroxinaemia is only transient, and does not prevent the post-natal T4 surge.

Absorption↗
PubMed1979

Cell mediated and local immunity to spermatozoa in infertility.

The possibility of the immunological factor as an etiological cause of infertility was investigated in 50 infertile couples. Of these, 31 couples were considered as an "unexplained sterility" group, while in the other 19 couples a variety of disorders were diagnosed. In vitro, leucocyte migration inhibition test (LMIT) was used for the detection of female cell-mediated immunity against sperm antigens. Sperm immobilization test (SIT) and sperm toxicity tests (STT) were used for the detection of antisperm antibodies in the cervical mucus. Out of the 31 "unexplained sterility" cases, six revealed a positive LMIT (5.3%). In 26 couples with an abnormal postcoital test (PCT), 10 cases had a positive SIT and STT (38.5%). However, out of the group of 16 couples with a normal PCT only in one case was a positive SIT and STT found (6.2%). The potential role of immunological reactions in infertility will be discussed.

Antibody Formation↗
PubMed1979

Vasa previa: a major complication and its management.

Vasa previa is an extremely rare condition. Consequently it is not often considered in the differential diagnosis of antepartum or intrapartum hemorrhage. Rupture of a fetal vessel may lead to sudden fetal death from exsanguination; therefore, this condition should be suspected in any antepartum or intrapartum hemorrhage. The blood that is lost should be tested for the presence of fetal hemoglobin. Other diagnostic tests to assess the degree of fetal distress are described. Four patients showing unusual presentations of vasa previa are reported. These cases demonstrate that fetal vessel rupture may occur independently of membrane rupture.

Adult↗
PubMed1978

Enhancement of fetal lung maturity by intra-amniotic administration of thyroid hormone.

Following preliminary results in animal studies demonstrating that thyroxine (T4) injected directly into the fetus or the amniotic sac is capable of enhancing fetal lung maturity, a trial of thyroxine treatment in mean was carried out. Two hundred micrograms of T4 were injected intra-amniotically in eight women with high-risk pregnancies in which premature delivery was inevitable or indicated. Fetal lung maturity was evaluated by a recently developed, accurate, and rapid method using the microviscosity value epsilon (this being the linear expression of the polarization value P) of the lipid assembly of the amniotic fluid as a parameter of the surfactant content. epsilon Values, which were very high before T4 injection, dropped steeply to below the value of 4.344, indicating fetal lung maturity. Eight newborn infants delivered, five by caesarean section, soon after the T4 injection did not develop respiratory distress syndrome, although they were born prematurely. Intra-amniotic injection of T4 appears to be of therapeutic value in enhancing fetal lung maturity.

Amnion↗
PubMed1978

Propranolol for the treatment of hypertension in pregnancy.

Twenty-five women were treated with propranolol during 26 pregnancies complicated by hypertension. The fetal wastage, which had been 48 per cent before treatment with propranolol was reduced to 15.4 per cent, with one missed abortion and three stillbirths. Of the 22 liveborn infants 2 were small-for-dates but all 22 had Apgar scores of 9 or 10 at five minutes. There were no congenital anomalies in 25 viable infants and none of the 22 liveborn infants had clinical or laboratory evidence of hypoglycaemia. The blood pressure was controlled in 17 of 19 patients taking propranolol alone (40 to 160 mg/day) and in 6 of 7 taking propranolol with diuretics.

Adult↗
PubMed1977

A survey of amniocentesis in 925 patients at high risk of fetal genetic disorder.

Over a nine-year period, 925 pregnancies at an Israeli medical centre were selected for investigation by amniocentesis for genetic reasons. In only 30 pregnancies did failure of laboratory methods or difficulty with amniocentesis lead to a lack of results with which to assess the normality of the fetus. The information obtained by examination of the amniotic fluid in the other 895 pregnancies is presented and discussed.

Abortion, Therapeutic↗
PubMed1977

Stilbestrol administration in the puerperium and its effect on the prolactin excretion of non-lactacting patients.

The relationship between stilbestrol treatment and placebo treatment was studied in 2 groups of non-nursing patients. Plasma prolactin levels were evaluated in these 2 groups on day 1, 3 and 7 of the treatment, by a radioimmunoassay technique with the double antibody method using Serono hPRL kit. Our results show that prolactin values increased significantly in the stilbestrol-group and decreased in the placebo group. It seems that the main reason for "the drying up of milk" is the lack of stimulation of the nipples, which after a releatively constant time of 5--10 days will lead to decreased prolactin levels. Stilbestrol treatment is not effective in "drying up" the milk more rapidly in patients who do not want to nurse. When patients have symptoms a combination of analgesia and breast support usually brings relief within 24 to 48 hours.

Clinical Trials as Topic↗