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Biomedical subjects

J Shime

Publications and source records attributed to J Shime.

24 records · Page 2Linked to original sources
PubMed1984

Prolonged pregnancy: surveillance of the fetus and the neonate and the course of labor and delivery.

The perinatal events in 184 term control pregnancies and 129 prolonged pregnancies were prospectively compared. Fetal surveillance consisted of weekly biophysical profile testing. Thirty-two infants were dysmature, and 10 of these had advanced dysmaturity. The incidence of advanced dysmaturity rose quickly after 44 weeks. This group was at greater risk for fetal distress, lower Apgar scores, and emergency cesarean section. The combination of oligohydramnios, a suboptimal nonstress test, and a low profile score was highly predictive of a neonate with advanced dysmaturity. In the control pregnancies, the rate of induction of labor was 13.81% compared with 39.84% in the prolonged pregnancies. The induced labor group had a 51.32% cesarean section rate. Our approach to prolonged pregnancy consists of elective induction of labor when the cervix is favorable and biweekly profile testing when it is not; however, the high incidence of advanced dysmaturity after 44 weeks warrants delivery.

Apgar Score↗
PubMed1984

Nonimmunologic hydrops fetalis.

Twenty cases of nonimmunologic hydrops fetalis were reviewed. The incidence of nonimmunologic hydrops fetalis was 1/2,029 (20 cases in 40,588 deliveries). The diverse etiologies of nonimmunologic hydrops fetalis are demonstrated. The incidence of erythroblastosis fetalis caused by Rh isoimmunization declined markedly. The perinatal mortality rate was 14/18 or 78%. Prematurity, the presence of congenital anomalies, and the severity of hydrops fetalis contribute to this poor prognosis. However, a better understanding of the pathophysiology of hydrops fetalis, along with early detection by ultrasonography, preterm delivery with the liberal use of cesarean section, and availability of high-risk perinatal units, may enable us to improve the prognosis. A precise diagnosis should be attempted by careful antenatal and postnatal evaluation, so that accurate genetic counseling can be offered.

Edema↗
PubMed1984

Two-dimensional and M mode echocardiography in the human fetus.

One hundred unselected pregnant women underwent M mode and two-dimensional fetal echocardiographic studies between 14 and 43 weeks' gestation. The following cross-sectional views were obtained: high parasternal short axis, parasternal long axis, four chamber view, and an extended long axis to assess the aorta. These views successfully identified great vessel orientation and size (90%), atrial and ventricular size and function (90%), presence of atrioventricular valves (92%) and semilunar valves (75%), and presence and continuity of ventricular and atrial septa (91%) and the aortic arch (68%). Factors that limited visualization were persistent unfavorable lie, maternal obesity, and oligohydramnios. Disturbances in cardiac rhythm were the prevalent abnormal findings (16%). In addition, several anatomic defects were detected in utero and confirmed at autopsy. These included a biventricular cardiomyopathy, atrial septal defect, pericardial effusion, and hypoplastic heart. The potential applications of our ability to detail human fetal cardiac anatomy and dimensions are discussed.

Arrhythmias, Cardiac↗
PubMed1984

Plasma levels of immunoreactive beta-endorphin and adrenocorticotropic hormone during labor and delivery.

beta-endorphin and adrenocorticotropic hormone (ACTH) are derived from the same precursor protein, and the plasma levels of beta-endorphin and ACTH are thought to be representative of the pituitary secretion of these peptides. Simultaneous measurements of immunoreactive beta-endorphin and ACTH were done on plasma samples from pregnant women at term and found to be normal, but a significant increase was observed during the stress of labor. Simultaneous measurement of immunoreactive beta-endorphin and ACTH in the umbilical vein at time of vaginal delivery demonstrated elevated levels of both peptides. The newborn also demonstrated an increased ratio of beta-endorphin to ACTH, of which the role is uncertain at present.

Adrenocorticotropic Hormone↗