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Biomedical subjects

E Shalev

Publications and source records attributed to E Shalev.

At least 145 records · Page 8Linked to original sources
PubMed1989

Selective reduction in multiple gestations: pregnancy outcome after transvaginal and transabdominal needle-guided procedures.

Selective fetal reduction was performed in the first trimester of pregnancy in 20 women with multifetal gestations after ovulation induction with human menopausal gonadotropin (hMG). In 10 women (group A) reduction was performed transabdominally, and in 10 women (group B) the transvaginal approach was used. The transvaginal technique achieved penetration of several gestational sacs without withdrawing the needle from the uterus. Fetal termination using either procedure occurred with intrafetal injection of potassium chloride. Six (60%, group A) and eight (80%, group B) patients delivered healthy newborns. One patient (group B) is at 30 weeks' gestation. Four (40%, group A) and one (10%, group B) aborted 1 day to 8 weeks after the procedure (1 septic abortion, each group). Our results suggest that transvaginal fetal reduction offers a better outcome, with minimal complications, to patients referred for selective continuation of pregnancy.

Abdomen↗
PubMed1989

Fetal motorical and heart response to sound stimulus in different behavioral states.

In 32 fetuses from 37 to 41 weeks' gestation, motorical and heart rate response time, as well as the influence of arousal state on that time were tested. Motorical response time was defined as the time from external stimulus to fetal movement. Heart rate response time was defined as the time from stimulus to the increase in baseline of 15 beats/min. Wide low frequent sound was used as external stimulus. No correlation could be found between motoric and heart rate response time (R = 0.26652). Among the various arousal states the lower arousal state had a significantly longer motorical and heart rate response time.

Acoustic Stimulation↗
PubMed1989

Prenatal diagnosis using sonographic guided cordocentesis.

Cordocentesis has been practiced as a diagnostical tool for prenatal diagnosis of intrauterine infections, hematological disorders, metabolic status of the fetus and rapid cytogenetic analysis. The performance of 198 cordocentesis is presented over 3 years of experience. A 21 gauge spinal needle is inserted via the optimal point on the maternal abdomen under real-time ultrasonic guidance into the insertion of the umbilical cord in the placenta. Successful cordocentesis were achieved in 98.5% of the cases. Termination of pregnancy was directly related to the procedure in only 1%. Hematoma surrounding the puncturing site was demonstrated in one case, but without damage to the fetus. In our series the main indication for performing cordocentesis was the need for rapid karyotyping. The use of fetal lymphocytes for chromosomal analysis offers a rapid and a reliable method for routine clinical demands. The availability of a rapid chromosomal analysis offers a considerable advantage in pregnancies of advanced gestational age. In those pregnancies it appears to be most important to have a rapid diagnosis where anatomical structural anomalies are associated with chromosomal malformations in up to 30%. The metabolic status of the fetus is considered in either acute distress or in cases of suspected sub-optimal metabolic hemostasis, where IUGR or oligohydramnios are demonstrated. Cordocentesis, even though is a new technique, turns to play a major role in modern perinatology. The possibility of a direct rout to fetal blood vessels early during the pregnancy bears the tremendous potential of early diagnosis and treatment.

Female↗
PubMed1989

Reliability of sonographic measurement of the fetal foot.

Reliability of sonographic measurement of the fetal foot was tested. Nineteen fetuses of 16 to 40 weeks gestational age were scanned by two physicians in two different planes of measurements. Repeatability of two measurements of each fetus by the same observer and agreement between the two planes was analyzed using the appropriate statistical method. Good agreement in repeated measurements for and between the two planes was found.

Embryonic and Fetal Development↗
PubMed1989

Fetal habituation to repeated sound stimulation.

Habituation is the progressive decrement of response with repeated stimulation. Neonatologists use this phenomenon to assess newborns for various pathological conditions of the CNS. The present study examined the time required for habituation of the startle response in 103 fetuses at various gestational ages (32 to 40 weeks). The external stimulus was produced by a door buzzer (80 to 90 db). Habituation time decreased as gestational age increased. About 85% of the fetuses showed habituation after less than 20 stimuli, and about 95% after less than 30 stimuli. In all cases habituation time never exceeded 50 stimuli.

Acoustic Stimulation↗
PubMed1988

Intracervical administration of prostaglandin E2-gel prior to therapeutic abortion: a prospective randomized double-blind study.

Forty primigravid women due to undergo first trimester termination of pregnancy were randomly selected for intracervical application of 1 mg prostaglandin E2 in gel or gel only as placebo. In the PGE2-gel group, a marked dilatation of the cervical canal was obtained, with post-gel treatment mean Hegar dilatation of 11.18 mm in that group, compared to 4.4 mm in the control group (P 0.001). Moreover, 16 (80%) patients in the PGE2-gel group had a complete abortion, one (5%) patient had an incomplete abortion and in the remaining three (15%) patients, fetal demise was observed. The mean induction-abortion interval in this group was 7.5 h. In the placebo group, none of the above effects were observed. The only side effect noted was vomiting, which occurred in five (25%) of the patients in the PGE2-gel group. Termination of pregnancy was found to be easier in the PGE2-gel group, compared to the placebo group.

Abortion, Therapeutic↗
PubMed1987

Ultrasonically controlled retrieval of an intrauterine contraceptive device (IUCD) in early pregnancy.

Removal of an intrauterine contraceptive device (IUCD) in nonpregnant patients under ultrasonic guidance has previously been reported, but results of the method in pregnancy are controversial. In the present study removal of the IUCD was performed in 16 women who conceived with the device in place. Four women were scheduled for pregnancy termination and 12 women wished to continue their pregnancy. Removal was successful in all 16 patients with minimal complications. Fetal loss occurred in one case out of the 12 who wished to continue their pregnancy. The procedure was found to be feasible even in cases with the IUCD located behind the gestational sac. We suggest ultrasonic guided removal of the IUCD during pregnancy to be the method of choice.

Adult↗