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Biomedical subjects

E Weiner

Publications and source records attributed to E Weiner.

At least 73 records · Page 4Linked to original sources

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↗

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↗

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↗

Detection of anticentromere antibodies using cloned autoantigen CENP-B.

A solid-phase enzyme-linked immunosorbent assay has been established using a cloned fusion protein, CtermCENP-B [beta-gal], as antigen. The fusion protein carries the major epitope of CENP-B, the major centromeric autoantigen. The enzyme-linked immunosorbent assay was more sensitive than immunofluorescence techniques in detecting anticentromere antibodies in patients with scleroderma or Raynaud's disease, and was weakly positive in 3% of normal controls and in 3% of 70 patients with other connective tissue diseases.

Adult↗

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↗

Assessment of gestational age by ultrasonic measurement of the femur length.

The effectiveness of ultrasonic femur length measurement from 12 to 40 week's gestation, as a means of assessing fetal age, was tested and compared with that of biparietal cephalometry. The femur length and biparietal diameter (BPD) were obtained from 471 measurements, from pregnant women with confirmed datings, using real-time scanning with a 3,5 mHz transducer frequency. Using a freeze frame and electronic calipers, the mean value of three consecutive measurements of the femur, when visualized with its characteristic appearance, was recorded. Linear regression analysis with the correlation coefficient of the femur growth-curve (r = 0.989, p less than 0.001) and that of the BPD (r = 0.985, p less than 0.001) showed that the former is as good as the latter. The femur growth-curve from 12 to 40 week's gestation with a mean +/- 2 SD was constructed. Estimation of fetal age by femur length measurement was compared with that assessed by the BPD in a further 54 women. A close correlation was found (r = 0.993, p less than 0.001). Measurement of the fetal femur appears to be a reliable method for assessing gestational age, which can compensate for the limitations of the BPD method.

Cephalometry↗

Colposcopic screening of women with atypical Papanicolaou smears.

A retrospective study was done on 575 patients with atypical Papanicolaou smears obtained during a ten-year period (1974-83) at Bellevue Hospital-New York University Medical Center. The smears were classified into three categories. The first consisted of 463 patients (81%) with inflammatory atypia specifically treated for Trichomonas, Monilia, Chlamydia, Gardnerella and atrophic vaginitis. Of them, 162 patients (35% of the group) had persistent inflammatory atypia 90 days after the beginning of therapy and were subjected to colposcopic examination. The second group consisted of 86 patients (15%) with squamous atypia. That group underwent colposcopic examination. The third group, 26 patients (4%), had endocervical atypia and underwent colposcopy and endocervical curettage. Overall, of 162 patients with persistent inflammatory atypia, 36 (22%) were found to have cervical intraepithelial neoplasia (CIN); of 86 with squamous atypia, 60 (70%) had CIN; and of 26 with endocervical atypia, 15 (58%) had CIN. Fifty-eight (28%) of all the patients with CIN had lesions of severity greater than CIN 1. It appears that all patients with persistent inflammation or squamous or endocervical atypia would benefit from colposcopic screening.

Biopsy↗

Prenatal diagnosis of placental hemangioma--clinical implication: a case report.

Placental hemangioma is considered to be associated with a high rate of maternal and fetal complications. We report a case where ultrasonography revealed the placental tumor at 28 weeks gestation. The patient was kept under strict surveillance which permitted diagnosis of pre-eclampsia at 34 weeks gestation with successful termination of pregnancy at 37 weeks. The ultrasonic features of the tumor are described and the clinical implication discussed.

Adult↗

Sexual and contraceptive experience among teenagers in Uppsala.

A questionnaire was offered to 181 sixteen-year-old boys (n = 88) and girls (n = 93) in different schools in the city of Uppsala. The questionnaire was introduced to the students by a nurse midwife during a regular lesson and included over 100 questions dealing partly with sexual education, attitudes towards sex and own experience of sex and contraception. Of the girls, 47% and of the boys, 31% answered that they had had intercourse. Twenty-eight per cent of the girls and 21.5% of the boys had had their first intercourse before the age of 15. Contraception was used at the first intercourse by 59% of the girls and by 70% of the boys. At the very first intercourse, the condom was the most commonly used contraceptive method. Increasing sexual experience changed the contraceptive pattern and at their last intercourse 48% of the girls were on the pill and 33% of the boys said that their girl friend was on the pill.

Adolescent↗

External bladder--amniotic fluid shunt for fetal urinary tract obstruction.

Ultrasound diagnosis of bilateral hydronephrosis, hydroureters, and megacystis together with oligohydramnios secondary to urethral stenosis was made in a male fetus at 29 weeks' gestation. In utero decompression of the obstructed urinary tract and expansion of the amniotic fluid was achieved by placing an external bladder-amniotic fluid shunt using two catheters, one inserted into the fetal bladder and the other placed in the amniotic sac. The infant was delivered by cesarean section at 35 weeks' gestation and had a favorable outcome.

Adult↗

Micrognathia-prenatal ultrasonographic diagnosis.

The first case of prenatal real-time ultrasonographic diagnosis of micrognathia is presented. Diagnosis was made at 17 weeks' gestation in the fetus of a patient with previous infant affected with the syndrome of thrombocytopenia with absent radii (TAR). Recognition of micrognathia as a part of TAR syndrome and the easy visualization of fetal facial bones in the second trimester made diagnosis possible.

Adult↗

Effects of continuous levonorgestrel treatment (subcutaneous capsules) on the lipoprotein and carbohydrate metabolism in fertile women.

The lipoprotein and carbohydrate metabolism was studied during contraceptive treatment with levonorgestrel, released at a low rate (70 micrograms/day) from subcutaneous capsules, in five women who were treated for 180-403 days. The serum cholesterol concentration decreased slightly but significantly during treatment. This was attributable to a tendency to a reduction of cholesterol in high-density lipoproteins. The treatment did not affect the lipoprotein lipase activity in adipose tissue. The elimination rates of intravenously injected fat and glucose were unchanged, as were the serum insulin concentrations. Thus, in this pilot study the concentration and composition of the serum lipoproteins altered to only a minor extent during treatment with levonorgestrel in a dose of 70 micrograms/day.

Adult↗