Calcified inferior vena cava thrombus in a fetus: perinatal imaging.
Explore the source record for details and available documents.
Calcinosis↗
Biomedical subjects
F Rodesch
Publications and source records attributed to F Rodesch.
Prenatal diagnosis of 52 pregnancies at risk for congenital cytomegalovirus infection.
OBJECTIVE: To determine the feasibility of prenatal diagnosis of fetal cytomegalovirus (CMV) infection. METHODS: Fifty-two pregnant women were investigated in our unit between October 1985 and July 1992. The diagnostic procedures included ultrasound examination, amniocentesis, and fetal blood sampling. Specific tests for CMV infection included specific immunoglobulin (Ig) M antibodies, viral culture, and amplification of CMV DNA by polymerase chain reaction. Nonspecific tests included white blood cell count, hemoglobin, hematocrit, platelets, and gamma-glutamyl transferase determination. RESULTS: The combination of tests allowed an antenatal diagnosis of CMV in 13 of the 16 infected fetuses (sensitivity 81%). Amniocentesis allowed the diagnosis in 12 of the 13 antenatally diagnosed cases. The sensitivity of CMV IgM antibody detection in fetal blood was 69%. The culture of fetal blood was never positive. Thrombocytopenia was present in six cases, and ultrasound was abnormal in five. CONCLUSIONS: Amniotic fluid is the best sample to diagnose CMV infection, and fetal blood sampling and sonography are important to assess the fetal condition. Our experience underscores the importance of repetitive sampling.
Amniocentesis↗
[Evaluation of umbilical Doppler parameters in relation to placental morphology in the third trimester of normal pregnancy].
The purpose of this study was to find out whether there was a relationship between placental morphology and velocimetric measurements of the umbilico-placental circulation. The Doppler parameters measured at the placental insertion of the umbilical artery between 28 and 40 weeks in 145 normal pregnancies were analysed in relation to placental maturation, as evaluated by real-time ultrasonography. A significant relationship between gestational age and fetal measurements was observed in relation to the ultrasonographic progress of placental maturity. As the placental grading changed from immature to mature, no variations in Doppler parameters and placental thickness were noted. It is concluded that anatomical placental changes evaluated by ultrasonography do not correlated with the changes observed in Doppler parameters during the third trimester of normal pregnancies.
Anthropometry↗
Nuchal cord in normal third-trimester pregnancy: a color Doppler imaging study.
A prospective study was performed in a normal, unselected, population of 180 pregnant women to assess the screening properties of color Doppler imaging in the detection of nuchal cord during the third trimester of pregnancy. A search was made for the umbilical cord position initially using conventional real-time gray-scale imaging and subsequently using color imaging. Umbilical artery resistance and pulsatility indices and maximum peak systolic velocity were measured in each case at the level of the placental cord insertion. Forty-five (25%) cases examined using color imaging presented with a nuchal cord at both ultrasound examination and delivery. Color imaging correctly identified in utero 28 (72%) single and 17 (94%) multiple nuchal cords found at birth. The overall sensitivity of color imaging in detecting nuchal cord prenatally was greater than for gray-scale imaging (79% compared with 33%). The sensitivity of color imaging was also higher after 36 weeks than before (93% compared with 67%). No difference was observed between the umbilical artery resistance and pulsatility indices. There was also no difference observed for the maximum peak systolic velocity between cases presenting with a nuchal cord (at both ultrasound examination and delivery) and controls matched for gestational age. We suggest that the clinical usefulness of systematic identification in utero of nuchal cord in pregnancies presenting with a normal fetus in the vertex position is limited, but might be of value in the management of breech and twin gestations, and also in the management of chronically growth-retarded fetuses.
Journal Article↗
Multifetal pregnancy reduction: comparison of obstetrical results with spontaneous twin gestations.
Thirty-two multifetal pregnancies were reduced to twin gestations. Our control group was composed of 32 spontaneous twin gestations. The comparison of these two groups did not show that the procedure altered obstetrical results as far as duration of gestation, birth weight and rate of dismaturity are concerned.
Abortion, Induced↗
Not all chorioangiomas are associated with elevated maternal serum alpha-fetoprotein.
Explore the source record for details and available documents.
Adult↗
Detection and evaluation of fetal goitre by ultrasound.
Antenatal diagnosis of fetal goitre has been reported rarely. Once detected, however, it is important to evaluate fetal thyroid function so early treatment can be initiated if necessary. In reporting three new cases, the authors analyse the various methods of evaluation. The normal sequence of appearance of the various epiphyseal ossification centres is an indirect illustration of thyroid function and can be followed by ultrasound. Direct evaluation of hormone levels through cord blood sampling under sonographic guidance is a complementary method in doubtful cases. The mechanisms predisposing to the development of fetal goitres and the possible implications of these findings are also discussed.
Diseases in Twins↗
[Prematurity: development during the last decade at Erasme Hospital, neonatal evaluation].
Our institution admitted 39 ELBW (less than 1 kg) between November 1978 and December 1990. In our center, mortality has decreased from 61% to 33% within a decade. Improvements in neonatal intensive care have lowered the limit for these possible survival to 26 weeks of gestational age and 700g of birthweight. Morbidity is still very high. The mean hospital stay is 96 days. Perinatal asphyxia is frequent (3/4) as well as infections, nutritional problems and renal failure. Sixty-six % of this population suffer from respiratory distress syndrome which is the main cause of death. Morbidity and mortality are explained and compared to the recent literature.
Belgium↗
[Collection of fetal cord blood for karyotyping].
Cordocentesis was performed in 234 pregnancies (241 fetuses) for rapid karyotyping. The indication was in 86% of cases: abnormal ultrasound. The abnormality encountered were IUGR (85 fetuses) or morphologic abnormality of the pregnancy (130 fetuses). The other indications were maternal mosaicism, mosaicism in cultured amniotic cells, maternal age (late booking), fragile X syndrome, confirmation of abnormal karyotype obtained by amniocentesis. The fetal karyotype was established in 97.5% (6 failures), 18 karyotypes were abnormal in the group "abnormal ultrasound" (208 pregnancies, 8.6%; 215 fetuses, 8.3%). No maternal complication were observed, there were 6 fetal losses (2.5%).
Blood Specimen Collection↗
[Fetomaternal alloimmunization: role of cordocentesis].
Twenty one pregnancies complicated by alloimmunization were managed by the use of intravascular method on an outpatient basis. One group was made of 9 women having had at least one pregnancy with a severely affected fetus. The other group was composed of 12 women without a previously affected infant; in 5 cases a situation at risk, either a transfusion (4 cases) or a severe obstetrical hemorrhage (1 case), was evidenced. Knowledge of fetal blood type (2 cases) and hematocrit determination obtained by fetal blood sampling allowed treatment individualized to the specific needs of each patient. In total 59 cordocenteses were performed, including 19 intrauterine transfusions.
Blood Transfusion, Intrauterine↗
Oxygen measurements in endometrial and trophoblastic tissues during early pregnancy.
Placental and endometrial partial pressures of oxygen (PO2) were measured using a polarographic oxygen electrode during the first trimester of pregnancy. Between 8-10 weeks' gestation, placental PO2 levels were significantly lower (P less than .001) than endometrial levels. A significant (P less than .001) increase was observed for placental PO2 values measured at 12-13 weeks compared with those obtained at 8-10 weeks. We suggest that the increase of placental PO2 at the end of the first trimester is related to the establishment of continuous maternal blood flow in the intervillous space.
Endometrium↗
Selective uterine artery embolization in the treatment of cervical pregnancy: two case reports.
Two patients presenting a cervical trophoblastic implantation were treated with selective uterine artery embolization associated with dilatation and curettage. This interventional radiological maneuver helped greatly in the management of the bleeding caused by the ectopic pregnancies.
Adult↗
Multifetal pregnancy reduction: a Belgian experience.
Multifetal pregnancy reductions were performed during the first trimester of pregnancy in 26 patients. Transabdominal intrathoracic KC1 injections were performed in 23 cases, and transcervical aspirations in 3 cases. There were 4 miscarriages (15%) during the second trimester, 18 pregnancies ended in 33 births, 4 pregnancies are going on uneventfully and are beyond 32 weeks. There was no maternal morbidity related to the procedure; fetal morbidity has been mild.
Abortion, Induced↗
Development of the secondary human yolk sac: correlation of sonographic and anatomical features.
Transvaginal ultrasound examination of the secondary yolk sac was performed in 145 first trimester pregnancies with a normal outcome (Group A), in 10 normal pregnancies undergoing artificial termination (Group B) and in 25 pregnancies that subsequently failed (Group C) due to embryonic death (n = 17) or to spontaneous abortion of a live embryo (n = 8). The yolk sac structure of all cases from Group B and from 12 cases of Group C were examined morphologically, in order to investigate the changes secondary to normal yolk sac senescence or to pregnancy complication and to evaluate the relationship existing between these changes and ultrasound features. The yolk sac diameter measured in vivo increased significantly between 6 and 10 weeks of gestation and then decreased significantly. Morphologically, the yolk sac showed degenerative changes after 9 weeks of gestation suggesting that the disappearance of the yolk sac in normal pregnancies was a spontaneous event of embryonic development rather than the result of mechanical compression by the expanding amniotic cavity. Yolk sac measurements in complicated pregnancies were not predictive of pregnancy outcome. Irrespective of gestational age, important degenerative changes were found in pregnancies complicated by embryonic death or disappearance, suggesting that variation of yolk sac size and appearance in these cases is the consequence of abnormal embryonic development of death rather than being the primary cause of early pregnancy failure.
Cytoplasm↗
[Chorionic villi sampling: experience of the initial 500 samples].
We report our experience in first trimester antenatal diagnosis since 1984. Transcervical chorionic villus sampling (CVS) was performed in 498 pregnancies. The rate of abnormal pregnancies was 6%, the rate of chromosomal abnormalities (trisomy) in the indication group "maternal age" was 2%. The fetal loss rate (until 28 weeks) was 3.4% (17 cases), the procedure related loss plus the background loss was 2.4% (12 cases). For 92.8% of the patients a diagnosis was available after 1 CVS procedure. Ultimately an antenatal diagnosis was given to 99% of the women through a second CVS procedure or an amniocentesis or a cordocentesis. No maternal complication was observed.
Chorionic Villi Sampling↗
[Fetal goiter: detection and echographic follow-up].
Ultrasonography of the neck in a 28 week-old fetus suggested the presence of a goiter. Since sonographic evaluation of epiphyseal ossification centers showed no delayed bone maturation, the fetus was considered to have an euthyroid goiter, that allowed amniocentesis to be performed. The fetus was sonographically followed from 32 to 36 weeks: the development was normal. At birth, hormonal tests confirmed an euthyroid goiter. The authors consider that bone maturation should be monitored in utero especially when a thyroid dysfunction is suspected, in order to detect severe disease and to prompt treatment.
Adult↗
[Cordocentesis: experience in 391 initial samples].
The first diagnostic cordocentesis was performed in our unit in october 1985. Our 4-year experience is reported: 391 cordocentesis were performed in 360 patients during gestational weeks 14 to 42. The first attempt was successful in 90% of the procedures, 4 samplings failed, there were 4 fetal deaths within one week after diagnostic cordocentesis, one of them appears to be directly linked to the punction. A transient fetal bradycardia was observed in 9.9% of the cases, bleeding occurred in 19% of the cases. The indications for cordocentesis were: risk of fetal infection, karyotyping, hemopathy, search for paternity, assessment of fetal acid-base status, biochemical dosage. Our data confirm that cordocentesis is a safe and reliable diagnostic procedure providing guidelines for management of the pregnancy.
Chromosome Aberrations↗
[Prenatal diagnosis using amniocentesis and chorionic villi sampling: comparative study of chromosomal findings].
The authors report the results of chromosomal analyses performed on 6235 amniocenteses and 559 choriocenteses. Whereas the frequencies of chromosomal anomalies observed respectively on amniocenteses and choriocenteses did not differ significantly, the comparison of the types of aberrations found revealed, in chorion villi, a relatively high proportion of lethal anomalies, never encountered in amniocyte cultures. Furthermore, chromosomal mosaicism was observed 10 times more frequently on chorion villi than on amniotic cells. These results are globally comparable to those reported in other surveys. In view of literature reports of discordances between fetal chorionic karyotypes, never found in amniocenteses, rapid karyotyping from chorion villi is not as reliable as from amniotic cells. Taking into account the risk of cytogenetic discordance specific to choriocentesis, it is recommended that this method be strictly limited to pregnancies with high genetic risk.
Amniocentesis↗