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Biomedical subjects

G Bernaschek

Publications and source records attributed to G Bernaschek.

At least 91 records · Page 5Linked to original sources
PubMed1995

[Meconium peritonitis: intrauterine follow-up--postnatal outcome].

In nine patients with meconium peritonitis prenatal ultrasonographic findings were correlated with the clinical course and outcome. Ultrasound findings included polyhydramnion (n = 4), ascites (n = 4), disseminated (n = 3) and solitary echogenic areas (n = 1), echopoor cystic areas (n = 3) and echogenic-echopoor solitary areas (n = 1). Intra-abdominal calcifications were found in five patients before delivery. Eight neonates survived and were subsequently followed up, one fetus died in utero. Four of the eight survivors required surgery, namely for meconium ileus (n = 1), perforation secondary to intestinal volvulus (n = 2) and inguinal hernia associated with prenatal rubella infection (n = 1). Three patients were healthy, one patient required drainage of pleural effusion and respirator therapy but recovered without further problems. Cystic fibrosis was diagnosed in the patient with meconium ileus. Postnatal outcome could not be predicted from the prenatal sonographic findings.

Adult↗
PubMed1994

The value of sonographic diagnosis of fetal malformations: different results between indication-based and screening-based investigations.

The advantages of a routine screening or indication-based ultrasound investigation during pregnancy are still under debate. This is the first study where both methods are compared in two different time periods. More malformations were diagnosed before the 24th week of gestation by means of screening-based than indication-based investigation (18 per cent vs. 5 per cent, P < 0.005), and before 28 weeks in 26 per cent compared with 15 per cent respectively (P < 0.01). Twenty-six per cent of all malformations were detected by means of screening-based investigations as opposed to 15 per cent by means of indication-based scans. Primary fetal malformations were also diagnosed much earlier (25 weeks vs. 30 weeks). Except for the fetal head, the detection rate of malformations was higher in nearly all other body regions of the fetus in the screening-based investigation. The most important advantage of a screening-based ultrasound investigation during pregnancy is to detect the malformations early enough in pregnancy for possible intrauterine treatment or to offer safe termination of pregnancy for the woman, at least for those anomalies that are lethal or significantly handicapping.

Congenital Abnormalities↗
PubMed1994

Feto-amniotic shunting--report of the experience of four European centres.

Few reports concerning intrauterine shunting are available. We investigated the impact of this method. In order to evaluate intrauterine shunting and the complication rate for different indications, we sent a questionnaire to all German-speaking level 3 centres. In four level 3 centres, 52 intrauterine catheters were inserted in 34 fetuses. The indications were uni- or bilateral hydrothorax in nine cases, cystic adenomatoid malformation of the lung in four cases, infravesical stenosis in 13 cases, and fetal ascites in eight cases. In three cases (6 per cent), difficulties occurred when the drain was inserted. In 15 cases (29 per cent), the function of the drain was reduced by dislocation or occlusion. The mortality rate caused by shunting was as high as eight per cent (four cases). The application of an intrauterine shunt currently represents a rarely performed ultrasound-guided therapeutic intervention in the fetus. In all cases, the indication for shunting is to avoid compression of normal tissue by cystic structures. A high complication rate restricts the application of drainage to selected cases.

Ascites↗
PubMed1994

Diagnosis and treatment of fetal anemia due to isoimmunization.

45 pregnant women affected by rhesus incompatibility were treated at the Department of Prenatal Diagnosis and Therapy, Vienna, between January 1992 and March 1993. 32 patients had a cordocentesis and on 21 fetuses, anemia requiring treatment was diagnosed. A total of 71 intravascular transfusions via the umbilical vein was given. The mean number of transfusions per fetus was 3.4 (range 1-11). Of the 7 fetuses who had already developed hydrops when therapy was started (hematocrit < 13%), 5 (71%) survived. The survival rate of non-hydropic anemic fetuses was 93% (13/14). By using intravascular transfusion for treatment of severe fetal anemia, a success rate of 86% (18/21) was achieved.

Blood Transfusion, Intrauterine↗
PubMed1994

Recurrent Dandy-Walker malformation.

This is a report of a 18 year-old woman with two consecutive fetuses suffering from a Dandy-Walker malformation (DWM). The first diagnosis of Dandy-Walker syndrome was at 24 weeks gestation. According to the parent's request, this pregnancy was terminated. Seven months after that event a new case of Dandy-walker malformation was diagnosed in the same woman. She was at 21 weeks of gestation.

Abortion, Eugenic↗
PubMed1994

"Voluvision": three-dimensional ultrasonography of fetal malformations.

OBJECTIVE: A new technique using three-dimensional ultrasonography and its performance in fetal malformations imaging was evaluated. STUDY DESIGN: A case of fetal complex malformation with bipartite scrotum combined with hypospadias and duodenal atresia is reported. RESULTS AND CONCLUSION: Three-dimensional ultrasonography provides important additional information in diagnosing fetal malformations.

Abnormalities, Multiple↗
PubMed1993

Fetal pulmonary cyst treated by repeated thoracocentesis.

This is a report of prenatal diagnosis and successful therapy of a septated fetal pulmonary cyst by repeated puncturing. This treatment was performed under ultrasonographic guidance for signs of fetal cardiac decompensation. This made normal development of the lungs possible.

Adult↗
PubMed1993

Vaginosonography for recording of cycle-related myometrial contractions.

It has been recognized from experimental or invasive studies that the nonpregnant human uterus has an inherent contractibility. We used vaginosonography for imaging contractions of the inner third of the myometrium. The direction, frequency, and symmetry of contractions were noted. We studied 53 women and subdivided them into four groups based on the cycle phase. During menstruation we found contractions toward the cervix with irregular frequency varying between 1 and 3/min. In the periovulatory period we noted the highest frequency of 10/min of regular contractions toward the fundus. The results showed that active myometrial contractions can be detected sonographically throughout the whole menstrual cycle. Increased myometrial contractions toward the fundus in the periovulatory period may be involved in sperm transport to the tubes.

Adult↗
PubMed1993

[Sonographic determination of the malignancy of ovarian tumors and therapeutic consequences].

Any Ultrasound investigation cannot reveal a histological diagnosis. There is a close correlation between sonographic characterisation of ovarian tumours and malignancy. Facts as size and structure of tumours, as well as papillarities on septae or walls of the cysts have much influence on the risk of malignancy. In cases with presence of papillarities in ovarian tumours a malignancy rate of 90% has to be expected. Contrary, simple, completely anechogenic ovarian cysts are benign with a probability of 98%. To improve the accuracy of prediction, we have to consider all other clinical aspects (age, anamnesis, tumour marker, etc.) We have to differentiate three steps concerning the risk of malignancy of ovarian tumours with subsequent different therapeutic management: the so called "simple Cyst", the "benign adnexal tumour" and the "malignant ovarian masses".

Biomarkers, Tumor↗
PubMed1993

[Echographic evaluation of the integrity of adnexa tumors].

The preoperative diagnosis of pelvic tumours is getting more and more important. This has special relevance to the increasing possibilities of conservative management of adnexal tumours and cysts (puncturing or operating by laparoscopy). We reviewed sonographical and histological data of 514 patients, who were operated on in the 2nd Department of Obstetrics and Gynaecology in Vienna because of pelvic masses. We correlated sonographical parameters like size of tumour, distinctness of margins, different kinds of internal echo pattern, papillary vegetation on the cystic wall or septa, with the defined histopathological diagnosis. A close relationship between size of tumour and tumour status could be found. The size of benign tumours was 7.1 cm. Malignant tumours had a size of 10.7 cm. The size of the high-echogenic area within the tumour, as well as its homogeneity, seemed to be of great importance. Such tumours with high-echogenic areas within, and especially those who had nonhomogeneous structures of these areas, proved to be malignant in 81% of the cases. Similarly, we found a close correlation of papillary vegetation either on cystic walls or on septa with the confirmed diagnosis of malignancy. Septa without papillarities or changing of their thickness were less important. By means of using our criteria a less experienced sonographic examiner could reach as good results as an experienced one in predicting malignancy.

Adenocarcinoma↗
PubMed1992

Current status of vaginosonography: a world-wide inquiry.

In the last 5 years, vaginosonography has become a routine procedure in obstetrics and gynecology. Many obstetricians, gynecologists, radiologists and ultrasonographers have recognized the advantages of this method. Nearly all manufacturers of ultrasound equipment offer several types of vaginal probes. The rapid spread of vaginosonography has also led to some disadvantages concerning the lack of standardized terminology and image display. In this study, we collected data about the current standards of vaginosonography. To obtain data, questionnaires were sent out to the 1107 Departments of Obstetrics and Gynecology in the FIG0 Registry 1985. In the accompanying letter, the chairman was asked to hand over the questionnaire to the appropriate specialist. The questionnaire was designed to gather information about the personnel performing vaginosonography and the techniques, transducer frequency, position of the patient and image display used. A total of 369 responses were received. Vaginosonographic investigations were performed in 84% of the University Departments of Obstetrics and Gynecology. In 90% of these, vaginosonography was performed by the obstetrician or gynecologist, in 4% by the radiologist and in 6% by the technician. Most departments preferred end-firing transducers. The numbers of electronic and mechanical probes were nearly identical (56% vs. 44%). The preferences for a scanner with a narrow (less than 120 degrees ) or wide angle (more than 120 degrees ) were very similar (53% vs. 47%). More than half of the responders (54%) used a transducer frequency of 5 MHz, while 46% preferred scanners with a frequency between 5.5 and 7.5 MHz. In 55%, the gynecological examination table was considered to be superior to a flat table. Of the responders, 52% projected the apex of the vaginal probe to the bottom of the ultrasound monitor. This was particularly the case in Europe (63%). Questioned about a preference for a particular orientation in the future, an additional 7% voted to change to this mode of image display world-wide. When performing a sagittal section, if the probe was projected to the bottom of the screen, dorsally located to the structures were projected twice as often to the left of the screen as to the right.

Journal Article↗
PubMed1992

Meconium peritonitis: extrusion of meconium and different sonographical appearances in relation to the stage of the disease.

By chance, we had the opportunity to make serial sonographic observations of the extrusion of meconium in a case of meconium peritonitis. Inflammation leads to exudative processes and production of fluid (ascites) in the fetal abdomen. Sonography at that stage of the disease may lead to a misdiagnosis such as 'fetal ascites' or 'non-immune hydrops'. After bowel perforation and extrusion of meconium, the latter appears as a solitary mass inside fetal ascites or as disseminated echogenic masses distributed subdiaphragmatically or perihepatically. Within a couple of days, in most cases the echogenicity of the masses increases. Calcifications lead to distinct shadowing. These calcifications are often the only visible signs of a previous meconium peritonitis. Serial sonograms are essential for the management of pregnancies with meconium peritonitis. If the amount of fetal ascites does not increase and no signs of cardiovascular stagnation appear, no invasive intrauterine diagnostic and therapeutic steps are required. In none out of the nine cases was a cause found.

Adult↗