Search PubMed⌕ Search

Biomedical subjects

I Blickstein

Publications and source records attributed to I Blickstein.

At least 109 records · Page 6Linked to original sources
PubMed1989

Transverse uterine incision for cesarean delivery of the transverse-lying fetus.

Low-isthmic transverse uterine incision was performed in 66 patients during Cesarean section indicated for transverse fetal lie. No significant differences were noted in the 1 and 5 min Apgar scores among fetuses delivered before or after rupture of the membranes. In only 5 (7.6%) of these cases was the incision converted into an inverted-T. The 1 min Apgar score was significantly lower in this group (6.0 +/- 1.3) compared to the rest of the group (7.5 +/- 1.7, P less than 0.01), however, the 5 min score showed no significant difference. No significant complications were noted in the post-operative course of mother and fetuses. We concluded that the transverse uterine incision is safe for the Cesarean delivery of the transverse-lying fetus.

Adult↗
PubMed1989

Recurrent spontaneous twinning.

The perinatal outcome of seven recurrent twin deliveries after 28 weeks gestation, was compared to the first twin delivery and to randomly selected controls matched for parity, maternal age and gestational age. The outcome of the recurrent twin gestation was associated with significantly increased gestational age (P less than 0.04) and mean twin birth weight (P less than 0.05) compared to the first twin pregnancy. When compared to controls matched for maternal age and gestational age they were of significantly higher parity (P less than 0.005) but had otherwise similar obstetric characteristics as when compared to controls matched for parity. These data suggest a better outcome for the recurrent compared to the first twin gestation. The frequencies of repeat twinning (0.0165% of all deliveries) and the calculated probability of having by chance a recurrent twin delivery were significantly different (P less than 10(-6)) suggesting that both deliveries may be stochastically dependent events.

Adult↗
PubMed1989

Isolated necrosis of the tubal fimbriae in a prepubertal girl.

A report of haemorrhagic necrosis of the tubal fimbriae in a prepubertal girl is presented. The presumptive aetiology for this is the isolated torsion of the fimbrial end which, to the best of our knowledge, has not been previously described. A high index of suspicion of torsion and early intervention is emphasised. Laparoscopy should usually precede laparotomy in doubtful cases but during laparotomy as little as possible should be done in order to retain future fertility.

Abdomen, Acute↗
PubMed1989

Simultaneous tubal and intra-uterine pregnancy following in vitro fertilization and embryo transfer.

A case of simultaneous ectopic and intra-uterine pregnancy following in vitro fertilization and embryo transfer (IVF-ET) is described. On day 56 after ET the tubal pregnancy ruptured, with massive hemoperitoneum. Following salpingectomy, the intra-uterine pregnancy continued to term when delivery was carried out by cesarean section owing to non-progress of labor and suspected fetal distress. The pitfalls in diagnosing a simultaneous pregnancy of this kind following IVF-ET are discussed.

Adult↗
PubMed1989

Second-breech presentation in twins--a possible adaptive measure to promote fetal growth.

Two hundred eighty-three longitudinally lying twin pairs were evaluated for the possible etiology of breech presentation in twins. Breech-breech pairs were delivered at a significantly earlier gestational age (P less than .02), because of significantly more deliveries (P less than .04) between 30-32 weeks, compared with vertex-second twins. Nevertheless, breech-breech pairs attained similar or larger birth weights when compared with other combinations. Discordant-second twins were found five times more frequently in breech-second pairs when twin A was in the vertex presentation. It is possible that breech-breech pairs reach a critical utero-fetal proportion earlier, resulting in earlier labor. Alternatively, twins may arrange in second-breech presentations as an adaptive measure to promote growth. We recommend special care for persistent breech-breech presentations diagnosed at the beginning of the third trimester.

Adult↗
PubMed1988

The obstetric perspective of neurofibromatosis.

Neurofibromatosis is a complex hereditary disease involving many organs and systems. A possibility of reciprocal adverse effects exists between the disease and pregnancy. A survey of the relevant literature suggests that management of the pregnant patient with neurofibromatosis is an obstetric challenge. After appropriate genetic counseling, patients with minimal or mild neurofibromatosis who wish to conceive should receive high-risk pregnancy care. Special attention should be directed toward maternal hypertension and the aggravating features of neurofibromatosis. The fetus may inherit the disease and also be at risk for growth retardation. Patients with severe neurofibromatosis should be advised not to conceive.

Female↗
PubMed1988

Complications associated with genital colonization in pregnancies with and without cerclage.

Cultures from the cervical milieu were taken from 24 antibiotic-treated patients (group A) and from 25 patients with no antibiotic treatment (group B). Both groups had undergone cerclage and were compared to 30 randomly chosen pregnant patients without cerclage (group C). Positive cultures were obtained in 70.8% and 48% before cerclage and in 66.7% and 68% after cerclage in groups A and B, respectively. These were not significantly different from group C (56.7%). Escherichia coli was found in over 75% of positive cultures. The rate of premature deliveries and premature rupture of the membranes were significantly higher in the cerclage groups. Maternal morbidity was significantly higher in group A compared to B and C. Our data suggest that bacterial colonization of the cervix and the vagina is not influenced by cerclage and antibiotics. It is concluded that cervical cerclage is associated with increased morbidity, therefore it is indicated only for definite anatomic and/or functional defects.

Administration, Oral↗
PubMed1988

Ritodrine-induced pulmonary edema unmasking underlying peripartum cardiomyopathy.

Pulmonary edema was induced by an increase in the dose of ritodrine in a patient receiving the drug for 28 days because of preterm contractions. After initial therapy, the cardiologic evaluation revealed peripartum cardiomyopathy. This is the first report of ritodrine causing pulmonary edema by unmasking underlying asymptomatic cardiomyopathy. This may have been the cause of some of the previously reported cases of ritodrine-induced heart failure.

Adult↗
PubMed1988

The growth discordant twin.

The study of growth discordancy in twin gestation has gathered great momentum in recent years. Divergent intertwin growth is believed to be a direct result of the process of twinning and of the inability of the uterine environment to provide for the increased demand of multiple fetuses. The smaller twin faces increased risk of perinatal mortality and morbidity as well as reduced physical and mental development in later life. The advent of ultrasonography enabled a fairly accurate prediction of growth disparity. Although extensive investigative efforts have clarified many questions regarding divergent twin growth, the question how to manage such pregnancies remains to be answered. The present article is a review of the literature concerning the clinical aspects of growth discordant twins.

Diseases in Twins↗
PubMed1988

Management of labor with umbilical cord prolapse: a 5-year study.

Fifty-one cases of cord prolapse, in which delivery was not imminent and the fetus was still alive, were managed by filling the bladder with 500-700 mL of saline and by intravenous ritodrine. Delivery was by cesarean section as soon as possible. Among the cases so managed, there were no perinatal deaths. The mean 5-minute Apgar score was 9.5, and in only three cases was it less than 7. In eight cases, fetal distress continued after treatment, as compared with 33 cases before this type of treatment started (P less than .001); no difference was found in the outcome between neonates weighing less than or greater than 2500 g.

Administration, Intravesical↗
PubMed1988

Growth discordancy in appropriate for gestational age, term twins.

We compared 14 term (37 weeks or more), discordant (15% or more birth weight difference), but not growth-retarded (2500 g or larger) twin pairs with 28 randomly selected term and appropriate for gestational age twin pairs without discordancy. The comparison of the two subgroups showed no significant difference in maternal age, parity, gestational age, incidence of maternal hypertension, or perinatal outcome. It is suggested that discordancy is not a risk factor when the twin pair has reached term and the lighter twin weighs at least 2500 g.

Birth Weight↗
PubMed1987

Re-evaluation of the obstetrical risk for the older primipara.

The obstetric data relating to 92 older primiparas (OP) treated as regular obstetric patients and data relating to 92 older multiparas (OM) are compared to a previous study of 98 OP, which led to the conclusion that OP should not be managed as high-risk patients during gestation. No difference was found between the two periods regarding complications of pregnancy, gestational age and birth weight, onset of labor, perinatal morbidity and mortality. Nevertheless, cesarean deliveries were significantly higher in the study group. It seems that the conservative attitude towards OP during pregnancy is justified, but at labor, more rigid indications for cesarean section should be applied to establish objective patient care.

Adult↗
PubMed1987

Predisposing factors in the formation of true knots of the umbilical cord--analysis of morphometric and perinatal data.

Fifty-four umbilical cords with a true knot were analysed and compared to 108 normal cords. True knots were found in 1.22% of births. They occurred at a significantly higher rate in longer cords (P less than 0.00001), in male fetuses (P less than 0.05) and in multiparous women (P less than 0.003). Signs of fetal distress were observed more frequently in female fetuses, especially in those with longer cords. A true knot seems to disrupt the significant correlation (P less than 0.007) between cord length and birth weight that we observed in controls. The present study reviews the literature on the subject and suggests a possible mechanism for true knot formation.

Birth Weight↗
PubMed1987

Vaginal delivery of the second twin in breech presentation.

The obstetric performance of 39 vertex-breech twin-pairs was compared with that of 48 vertex-vertex pairs. No difference was found between the two groups in maternal age, parity, gestational age, birth weight, and Apgar scores. The second twin in breech presentation had a higher incidence of very low birth-weight (less than 1500 g), but of borderline significance (P = .05), and a significantly (P less than .03) longer hospitalization period. The cesarean section rate was 7.7 and 10.4% for the breech and vertex second twin, respectively. In our view, breech presentation of the second twin is not an indication for cesarean section.

Apgar Score↗