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Biomedical subjects

J Deutinger

Publications and source records attributed to J Deutinger.

At least 55 records · Page 3Linked to original sources
PubMed1996

Fetal lung volume determination by three-dimensional ultrasonography.

OBJECTIVE: Pulmonary hypoplasia is common in compromised pregnancies. However, prenatal diagnosis by volume measurement has not become routine until now. The performance of three-dimensional ultrasonography in fetal lung volume determination was evaluated in this study. STUDY DESIGN: In a total of 78 singleton pregnancies 108 measurements were performed. Lung volume was calculated by subtraction of the fetal heart volume from the volume of the fetal thorax. RESULTS: Linear regression of transformed fetal lung volume growth gave best results (R2 = 0.77, p < 0.001), ranging from 2.8 ml at 14 weeks' gestation to 148 ml at term. CONCLUSION: Three-dimensional ultrasonography provides not only access to surface rendered images but it also enables more sophisticated volume measurements. In this study three-dimensional ultrasonography provided fast, easy access for volume estimation of the fetal lung. This technique can be used to reasonably predict fetal lung volume.

Female↗
PubMed1996

[Doppler ultrasound in cases of Rhesus incompatibility. Effect of intravascular punctures with or without transfusion on feto-placental Doppler blood flow velocity curves].

OBJECTIVE: To investigate the influence of cordocentesis with or without blood transfusion on umbilical and fetal blood flow characteristics. METHODS: Of 42 pregnant women suffering from Rh. incompatibility 15 had a puncture of the umbilical cord for diagnostic reasons only. In 27 cases a total of 86 punctures was done for blood transfusion. Fetal heart rate, umbilical artery A/B Ratio and Pulsatility Index (PI) in the fetal aorta were measured before and after cordocentesis in all cases having or having not a transfusion. RESULTS: Diagnostic and therapeutic cordocentesis resulted in a slight decrease of peripheral resistance. Significant differences were only observed in cases with a haematocrit < 20% compared to cases with values > 40% or if the final haematocrit after transfusion resulted in a value of < 30%. CONCLUSION: The decrease peripheral resistance in cases of therapeutic cordocentesis can be attributed to the increase in blood volume and sufficient oxygenation of blood improving fetal perfusion. Doppler sonography is not helpful in the clinical management of red blood cell immunisation.

Adult↗
PubMed1996

[Does the risk of complications after amniocentesis depend on the indications for intervention? An evaluation of 2,066 punctures].

Data from 2066 amniocenteses were analysed retrospectively to test the hypothesis whether the indications for amniocentesis influence the risk of post-procedural complications. Compared to the reference group of 35-39 year-old gravidae, the complication rates were similar in women with a previous child with chromosomal abnormality, in cases with maternal disease, abnormal biochemical markers, maternal anxiety, and translocation carriers. If the maternal age was 40 years and over, only the percentage of pregnancy terminations for fetal abnormalities was higher than in the reference group; high parental age was associated with a significantly decreased fetal loss rate. In the group of amniocenteses performed for sonographic evidence of fetal malformation, the highest total complication rates and the highest fetal loss rates were observed.

Adult↗
PubMed1996

Chromosomal abnormalities: how much can we predict by ultrasound examination in low-risk pregnancies?

We examined the rates of chromosomal anomalies detected by ultrasound investigations for the whole region of Vienna. We evaluated the data of 250 private offices, 10 clinics for Obstetrics and Gynecology, and one university Department of Prenatal Diagnosis and Therapy during the period from January, 1990, to July, 1991. The study group consisted of low-risk patients, since cases where prenatal karyotyping has been performed for other reasons than sonographic findings (for example, maternal age) were excluded from the study. An overall detection rate of 53.7% was found for the region. Structural malformations of fetuses (41.5%) were the most prominent factors leading to the diagnosis of chromosomal abnormalities. In addition, detection rate of trisomy 21 (17.6%) by prenatal ultrasonography was found to be significantly lower compared to all other chromosomal abnormalities in our study (50 to 100%).

Austria↗
PubMed1995

Sonographic depiction of fetal tooth germs.

Recently, sonography of the fetal face has gained increasing importance in prenatal diagnosis. It is not yet clear whether sonographic depiction of fetal tooth germs would have an influence on the prenatal diagnosis of ectodermal dysplasia syndromes. During routine malformation screening, horizontal sections of fetal jaws were visualized and examined for tooth germs in 124 pregnant women following sonographic 'facing'. Histological jaw sections of fetuses that had died in utero at various gestational ages were produced in order to examine the degree of correspondence between the sonographic and histological findings. At least four tooth germs were found in the jaws of all fetuses between 19 and 34 gestational weeks (n = 104). Although jaw visualization was possible between 14 and 18 gestational weeks (n = 20), the exact number and location of the tooth germs could not be determined. Assessment of tooth germs may become increasingly important, as aplasia of the tooth germs is one of the principal signs of various hereditary ectodermal diseases.

Anodontia↗
PubMed1995

Complications of cordocentesis in high-risk pregnancies: effects on fetal loss or preterm delivery.

Between 1990 and 1993, 166 cases underwent cordocentesis and were followed for at least the following 4 weeks in the Prenatal Diagnosis and Therapy Centre of Vienna University. The indications for the procedure were structural malformations in 46.4 per cent of the cases, other high-risk diagnosis in 48.8 per cent, and maternal age over 35 years in only 4.8 per cent. We investigated retrospectively all cases of complications resulting in fetal loss or preterm labour. Abortion, intrauterine fetal death, chorioamnionitis, and preterm delivery occurred in 0.6, 5.4, 0.6 and 9.0 per cent of these cases, respectively, adding up to a total of 26 cases (15.7 per cent). Although this rate looks relatively high, 20 of the 26 cases had already displayed signs implying a complicated prognosis. Neither maternal age, gestational age, number of attempts, nor placental location correlated with fetal loss or preterm delivery. Significantly higher rates of fetal loss or preterm delivery were observed when cordocentesis was performed in cases diagnosed as duodenal/intestinal stenosis or hydrops-ascites-hydrothorax/hygroma colli (P = 0.0488 and P = 0.0005). The frequency of complications did not decrease as the experience of the operators increased.

Abortion, Spontaneous↗
PubMed1995

Localization of blood vessels and qualitative assessment of blood flow in ovarian tumors.

OBJECTIVE: To study the localization of blood vessels within a tumor and the shape of the flow curve as a method of assessing ovarian neoplasms. METHODS: We studied 39 patients with malignant tumors and 63 patients with benign ovarian tumors by means of vaginal color Doppler ultrasound, noting the localization of blood vessels in the tumors, the shape of the flow curve, and peripheral resistance. RESULTS: Blood vessels could be visualized in 95% of the malignant tumors and in 70% of the benign tumors. Blood vessels tended to be localized centrally (65 versus 5%) in malignant tumors and peripherally in benign tumors (65 versus 0%). A diastolic notch was seen in 89% of the benign tumors, but in none of the malignant tumors. The mean resistance index (RI) +/- standard deviation was 0.48 +/- 0.19 in malignant and 0.69 +/- 0.09 in benign tumors (P < .05). The corresponding values for the pulsatility index (PI) were 0.56 +/- 0.13 and 1.06 +/- 0.07, respectively (P < .01). CONCLUSIONS: Low RI and PI values are general indicators of tumor growth. The localization of blood vessels within an ovarian tumor and the presence or absence of a diastolic notch are the most useful variables in the evaluation of ovarian tumors.

Adult↗
PubMed1995

Three-dimensional ultrasound in diagnosing phocomelia.

Deformations of the extremities with limb reduction are rare congenital defects which affect one in 1692 live babies. Three-dimensional ultrasound can be of value in the prenatal diagnosis of such deformities. We present a case of upper phocomelia and congenital thrombocytopenia (TAR syndrome). Visualization of the upper extremities was achieved by three-dimensional ultrasound after surface and volume rendering. This new technique allows imaging not only of surfaces like the fetal skin, but also of internal structures like the fetal skeleton.

Adult↗
PubMed1995

[Prenatal management of fetofetal transfusion syndrome].

The twin-twin transfusion syndrome is a rare but severe complication in monozygotic twins. A total of 172 twin pregnancies were investigated in our hospital between January 1990 and August 1993. The patients were divided into 4 groups: Group I: Normal twin pregnancy, treatment only in our hospital. Group II: Twin-twin transfusion syndrome, treatment only in our hospital. Group III: Normal twin pregnancy, delivery in another hospital. Group IV: Twin-twin transfusion syndrome, after treatment and therapy delivery in another hospital. These cases were analysed concerning prenatal management and perinatal outcome. The perinatal mortality rate in group I-IV was 17%, 58%, 18% and 60%, respectively. A benefit of aggressive amniocentesis in case of polyhydramnios, administration of digoxin and timing of labour could be demonstrated.

Adult↗
PubMed1995

Three dimensional ultrasound: abnormalities of the fetal face in surface and volume rendering mode.

OBJECTIVE: To evaluate three dimensional ultrasound in surface and volume rendering mode in fetal malformations of the face. SETTING: Day assessment unit in a university hospital. SUBJECTS: Four cases have been examined: two cases represented cleft lip, one case was a male with trisomy 13 (Patau syndrome) with proboscis, and one case represented a male fetus with unilateral anophthalmia. CONCLUSION: A new technique of three dimensional ultrasound visualisation in fetal malformation using surface and volume rendering is presented. The equipment consisted of a commercially available ultrasound machine, a built-in graphic workstation, and three dimensional software. Post-processing of data required approximately 10 minutes of calculation. The application of three dimensional ultrasound in complex malformations of the face appears to provide reasonable value for prenatal diagnosis and may become clinically useful in the near future.

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↗
PubMed1994

[The triple test].

Until the late 80s advanced maternal age was the main indication for prenatal chromosomal diagnosis. The triple test has introduced a noninvasive method for all women to determine the risk of chromosomal abnormality. Not only women aged over 35 years, but also those less than 35 years of age may benefit from the triple test. An exactly performed triple test will allow a diagnosis in 70% of all cases with trisomy 21. Additionally, a positive triple test will be found in 9% of all screened women. 1-2% of the women with a positive triple test will exhibit a fetus with trisomy 21. A false-negative result will be found in 0.1%. Beside trisomy 21, the triple test allows also the diagnosis of pregnancies with a high risk of trisomy 18 and Turner syndrome. The value of the triple test is mainly determined by the quality of the laboratory and the exactness of the determination of the gestational age, which is done mainly by means of ultrasound. Ultrasound investigation also provides information about structural abnormalities. In future the triple test will increase in accuracy and it will be performed in the first trimester.

Chromosome Aberrations↗