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Biomedical subjects

E Shalev

Publications and source records attributed to E Shalev.

At least 109 records · Page 6Linked to original sources
PubMed1993

Fetal circulatory endothelin-1,2 in the midtrimester.

Umbilical-vein blood from eight fetuses who underwent cordocentesis for rapid karyotyping at 19-22 gestational weeks was tested for immunoreactive endothelin-1,2 by means of radioimmunoassay. Endothelin was detected in the serum of all but one of these fetuses. Levels of endothelin-1,2 ranged from 8.5 to 19.2 fmol/ml (mean 13.4 fmol/ml). We speculate that endothelin in the fetoplacental circulation may play a role in the regulation of fetal hemodynamics in utero.

Cordocentesis↗
PubMed1993

Management of functional ovarian cysts after induction of ovulation. A randomized prospective study.

To investigate the need for hormonal treatment in patients with functional ovarian cysts after induction of ovulation, a randomized prospective study was performed. Fifty-four patients who were found to have ovarian cysts after induction of ovulation were randomly assigned to two groups: a) Treatment with estrogen/progesterone. b) Expectant management. The main outcome measure was resolution of ovarian cysts. There was no significant difference between the groups. We conclude that hormonal treatment is not necessary in cases with functional ovarian cysts after induction of ovulation.

Adult↗
PubMed1993

External cephalic version at term--using tocolysis.

Fifty-five patients with non-vertex presentation at 37 to 40 weeks' gestation were evaluated to determine which factors were associated with a successful external cephalic version (ECV). Maternal parity, obesity, amniotic fluid volume, placental location, type of breech and position of fetal spine were analyzed. Only amniotic fluid volume and fetal weight were significantly associated with a successful version (p < 0.05), 40/55 (73%) were successfully converted, 36/55 (65%) were vertex at delivery, and 32/55 (58%) delivered vaginally. Version attempts were successful in six out of eight patients who had undergone a previous cesarean section. Two out of six of the successful version patients went on to have vaginal birth after cesarean section. We conclude that although ECV is a reasonable alternative in the management of pathological presentation near term it should be performed only when there is sufficient amniotic fluid volume.

Breech Presentation↗
PubMed1993

A possible effect of ultrasound on RNA synthesis in cultured amniocytes.

The effect of both diagnostic and therapeutic ultrasound on cellular RNA synthesis was investigated in amniocytes cultured in F-10 medium enriched with fetal calf serum. The rate of RNA synthesis was tested using incorporation of H3 uridine, which was added following the exposure to acid insoluble RNA. Cultured amniocytes which were not exposed to ultrasound served as the control. Different results were obtained following the two ranges of exposure. A significant decrease in RNA synthesis was demonstrated immediately following diagnostic ultrasound and a certain increase in RNA synthesis was demonstrated soon after exposure to therapeutic doses. These effects were transient and could not be shown 24 hours later. It is concluded that the routine use of ultrasound can not have any clinical implications on RNA synthesis.

Amniotic Fluid↗
PubMed1993

Laparoscopic treatment of adnexal torsion.

Adnexal torsion remains an infrequent and difficult to diagnose gynecologic emergency. Until recently, laparoscopic diagnosis was followed by laparotomy. Now, with proper laparoscopic technique, it is possible to untwist the adnexa or to remove it with excellent results. We report herein our cumulative four year experience with laparoscopic detorsion or removal of the adnexa in 41 patients. Ten patients were simultaneously pregnant, seven having the ovarian hyperstimulation syndrome, six with paraovarian cysts and 18 with idiopathic torsion. All of the women had an uneventful recovery, with 14 of 19 patients who claimed desire for pregnancy becoming pregnant within one year after the procedure, emphasizing its advantages and safety.

Adnexa Uteri↗
PubMed1992

First-trimester ultrasonic diagnosis of twin reversed arterial perfusion sequence.

Twin reversed arterial perfusion (TRAP) syndrome sequence is a rare specific anomaly of twin gestation with fused placentae and umbilical anastomosis. This syndrome occurs once in very 35,000-48,000 births and has been described in the second trimester (23-29 weeks of gestation). We report on early sonographic diagnosis (10 and 12 weeks' gestation) of two cases of TRAP sequence, together with their umbilical cord Doppler studies.

Adult↗
PubMed1992

High levels of maternal serum alpha-fetoprotein and human chorionic gonadotrophins leading to the diagnosis of combined neural tube defect and partial mole.

A case of combined partial mole and neural tube defect is presented. The detection of high levels of both maternal serum (MS) alpha-fetoprotein (AFP) and human chorionic gonadotrophin (hCG) during the second trimester led to the ultrasonic demonstration of anencephaly, omphalocele, and partial mole. This is the first report of combined elevation of MSAFP and MShCG.

Adult↗
PubMed1992

Ultrasonic diagnosis of mediastinal cystic hygroma.

The incidence of cystic hygroma, which represents dilated obstructed jugular lymph sacs, is 1 in 6000 pregnancies. Cystic hygromas can be located in the nuchal area or in any other location. The prenatal ultrasonic diagnosis of a cystic hygroma in the mediastinum is presented.

Adult↗
PubMed1992

Retrograde seeding of endometrial carcinoma during hysteroscopy.

Fractional dilatation and curettage remain the most reliable methods in the diagnosis of endometrial carcinoma in the symptomatic patient. In the past few years hysteroscopy has become a helpful method, improving the specificity of the diagnosis of this pathology. We report a case of clinical stage IA grade 2 endometrial adenocarcinoma diagnosed by hysteroscopy and endometrial biopsy. Surgical staging revealed positive cytology. We suggest that irrigation of the endometrial cavity during the hysteroscopic procedure with saline may disseminate the disease to the abdominal cavity and may change the prognosis and the course of treatment.

Adenocarcinoma↗
PubMed1992

Relapsing thymic carcinoma during pregnancy.

A 23 year old woman, who was known to be in remission from thymic carcinoma, presented in her first trimester. She had previously been treated with radiation and chemotherapy. Her pregnancy was complicated by fever and contractions at 30 weeks and ended with the birth of a live preterm male infant. Subsequent investigation revealed a massive relapse of her mediastinal tumor. This case reinforces the devastating consequences that pregnancy has on thymic hyperplasia. Of nine previously reported cases, five of the women died either during pregnancy or within six months and only one was alive longer than five years. Therapeutic abortion should be considered in the pregnant woman with known thymic neoplasia.

Adult↗
PubMed1991

[Ultrasonic estimation of fetal weight].

To generate formulas to estimate fetal weight on the basis of sonographic measurements, 226 pregnant women were scanned within 3 days of delivery. Measurements included: biparietal diameter, head circumference and area, abdominal circumference and area, and femoral length. The contribution of each parameter to the estimation of fetal weight was tested by stepwise regression analysis. The best dependent variable was found to be the log of weight. The formula based on cranial and abdominal parameters proved to be inaccurate, especially when fetal weight was less than 2500 g. The addition of femoral length improved weight estimation, with a multiple r of 0.95174. The addition of gestational age led to even more accurate formulas. The most accurate found was based on biparietal diameter, abdominal circumference, femoral length and gestational age, with a multiple r of 0.95651 and an absolute mean error of 7.976 +/- 5.657%. It also produced better weight estimates at the 2 extremes of fetal weight.

Anthropometry↗
PubMed1991

Ectopic pregnancy: sonographically-guided transvaginal reduction.

The advanced modalities of vaginal ultrasonography and sensitive human chorionic gonadotropin assays have greatly facilitated the diagnosis of early ectopic pregnancy. The treatment spectrum for ectopic pregnancy ranges from a variety of conservative operative measures, including salpingectomy and operative laparoscopy, to various medical regimens or simply watchful observation alone. We report 12 cases in which the ectopic gestation was treated by transvaginal instillation of potassium chloride or methotrexate under sonographic guidance. Three of these, one of two patients receiving potassium chloride and two of six patients receiving methotrexate, later required a laparotomy. The level of beta-subunit of human chorionic gonadotropin was found to be unreliable in predicting the outcome in these patients. Ultrasound follow-up is mandatory. A protocol for treatment is presented.

Journal Article↗