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Biomedical subjects

J W Seeds

Publications and source records attributed to J W Seeds.

At least 55 records · Page 3Linked to original sources
PubMed1988

The relationship of obstetric ultrasound to parent and infant behavior.

There is inconsistency in the obstetric literature regarding the relationship between the mother's knowledge of fetal health gained by ultrasound and maternal psychological attachment to the fetus. To evaluate the relationship more precisely, this study assessed variables of physician-patient interaction, parental mental health in pregnancy and infancy, and 3-month infant and parent behavior. The results show that maternal mental health scores increased as a function of the stress associated with an "at risk" pregnancy necessitating ultrasound assessment. As the parent received more definitive information, scores on measures of anxiety, depression, and hostility decreased. There was no significant relationship, however, between definitive information gained through ultrasound and later parent and infant behavior in play interaction. Shifts in fetal and neonatal health status and the positive interaction between physician and parent suggest the need for further analysis.

Adolescent↗
PubMed1988

Elevated maternal serum alpha-fetoprotein with normal ultrasound: is amniocentesis always appropriate? A review of 26,069 screened patients.

We reviewed our experience with a policy of revising the estimated probability of an open neural tube defect for those cases in which maternal serum alpha-fetoprotein (MSAFP) was elevated and the ultrasound examination was normal. Assuming a sensitivity for the ultrasound diagnosis of neural tube defects of 90%, the risk estimate derived from the MSAFP was reduced by that amount when ultrasound was adequate and normal. When counseled regarding this revised risk estimate, 67% of our patients declined amniocentesis. The sensitivity for the ultrasound diagnosis of anencephaly in our series was 100%; for open spine defects, 80%; and for all open neural tube defects, 91%. The two patients in whom an open spine defect was not detected with ultrasound had elevated revised risk estimates. When appropriate criteria are met, the estimated sensitivity of ultrasound in diagnosing open neural tube defects may be used for counseling patients at risk for a fetus with an open neural tube defect.

Amniocentesis↗
PubMed1988

Elevated maternal serum alpha-fetoprotein with oligohydramnios: ultrasound evaluation and outcome.

Nineteen pregnancies evaluated for elevated maternal serum alpha-fetoprotein levels were found to have moderate to severe oligohydramnios. There were no survivors among six fetuses with ultrasound-diagnosed urinary tract anomalies. We followed 11 of the remaining 13 pregnancies with serial ultrasound examinations. When the second ultrasound examination demonstrated severely decreased amniotic fluid, the outcome was always poor (intrauterine death, perinatal death, or fetal deformations). Of the five cases in which the second ultrasound showed normal to moderately decreased fluid, there were four surviving infants. When no primary malformations are seen on the initial ultrasound examination, serial ultrasound evaluations of amniotic fluid volume help predict the pregnancy outcome.

Abortion, Induced↗
PubMed1988

Early prenatal diagnosis of familial lipomyelomeningocele.

This report describes and illustrates the early prenatal diagnosis of a familial recurrence of congenital lipomyelomeningocele. Diagnosis was made from longitudinal and transverse ultrasound views of the fetal spine at 17 weeks' gestation showing a fourth echogenic area in the lumbosacral dorsal midline. Early diagnosis and resection of this often harmless-appearing, rare teratomatous tumor of the spinal cord is necessary to prevent irreversible neurologic damage during childhood. Familial recurrence has not previously been documented. This case emphasizes that reproductive counseling after the birth of an infant with a rare malformation must always include the possibility of recurrence. The antenatal sonographic and neonatal appearance is presented.

Adult↗
PubMed1988

Polyhydramnios and oligohydramnios in twin gestations.

Seven twin pregnancies with concurrent polyhydramnios and oligohydramnios resulted in a perinatal mortality rate of 71%. The occurrence of this complication before 26 weeks' gestational age resulted in deaths of all fetuses, despite a variety of attempted therapies.

Abortion, Induced↗
PubMed1987

Prenatal sonographic diagnosis and management of a twin pregnancy with placenta previa and hemicardia.

The sonographic diagnosis of a twin pregnancy complicated by acardius anceps of one fetus, total placenta previa, uterine overdistension, and preterm labor is presented and management is discussed. Attempted selective fetocide is described, but was not successful. Clinical management of severe discordant sonographic dysmorphology is discussed, and diagnostic criteria for sonographic diagnosis of acardia are presented.

Abnormalities, Severe Teratoid↗
PubMed1987

Single-probe spectrophotometry in the assessment of fetal oxygenation.

Six sheep fetuses were monitored with a single-probe tissue spectrophotometer. This spectrophotometer provides continuous digital output of the index of hemoglobin that is saturated with oxygen. To vary the fetal pO2, each maternal ewe was given room air, 100% oxygen, 12% oxygen, and 100% nitrogen via rebreathing bag. Fetal venous (N = 4) or arterial (N = 2) blood was analyzed for pO2. There was excellent correlation between the index of hemoglobin saturated with oxygen and the fetal pO2. The single-probe spectrophotometer overcomes two of the technical problems encountered when a double-probe spectrophotometer is used.

Animals↗
PubMed1986

Ultrasound-guided fetal intravascular transfusion in severe rhesus immunization.

The successful use of ultrasound-guided fetal umbilical venipuncture and direct intravascular transfusion in a case of severe hydrops fetalis at 28 weeks' gestational age is described. Complete reversal of the hydropic changes was observed in utero. The use of this new technique in fetal treatment of Rh disease is discussed.

Adult↗
PubMed1986

Prevention of fetal movement during invasive procedures with pancuronium bromide.

The use of fetal intramuscular pancuronium (0.5 mg) to temporarily arrest fetal movement during antenatal intervention in six instances is reported. Successful arrest of movement without adverse side effects was observed. The use of this technique eliminates the need for the excessive and potentially dangerous maternal sedation currently used to minimize fetal movement.

Female↗
PubMed1986

Femur length versus biparietal diameter for estimating gestational age in the third trimester.

It is well established that ultrasound measurement of femur length and biparietal diameter are comparably accurate estimators of gestational age when obtained in the first half of pregnancy. Both estimators, however, become less accurate later in pregnancy. The present study compares the relative accuracy of these estimators when obtained in the third trimester. It is concluded from linear regression analysis that the correlation between gestational age estimated from femur length and the actual gestational age is stronger than that between gestational age estimated from biparietal diameter and actual gestational age. Furthermore, gestational age calculated from femur length is significantly more likely to be within 2 weeks (P less than or equal to .01) and 3 weeks (P less than or equal to .05) of actual gestational age than is gestational age calculated from biparietal diameter. Estimating gestational age from the mean of the gestational age based on biparietal diameter and that based on femur length is less accurate than estimating gestational age from femur length alone.

Cephalometry↗
PubMed1986

The relationship between mean abdominal diameter and femur length in normal and impaired fetal growth.

The relationship of fetal mean abdominal diameter (MAD) to fetal femur length (FL) in clinically normal pregnancies and 37 cases of intrauterine growth retardation (IUGR) was studied. The normal relationship of FL to MAD is closely described by the equation: log (MAD) = 3.326 + (0.185 X FL). r = .953, P less than .001. In the growth retarded infants, 59% of the abdominal measurements fell below the lower 75% confidence limit. Of the abdominal measurements derived from infants with birthweight greater than 2 SD below the mean for gestational age, 86% fell below the lower 75% confidence limit. These data show the MAD is selectively depressed in many, but not all cases of IUGR and particularly in the more severely affected infant, but the technique is not sufficiently discriminant to be used by itself for the detection of IUGR. Detection of an anomaly of this relationship would be strong supportive evidence of IUGR independent of gestational age and possibly identifies infants growth retarded specifically due to chronic deprivation.

Abdomen↗
PubMed1986

Fetal growth response to total parenteral nutrition in pregnancy. A case report.

Although clinical experience with total parenteral nutrition (TPN) in pregnancy is accumulating, assessment of the fetal growth response to this therapy has been limited primarily to birth weight. We performed serial ultrasonographic measurements of the fetal biparietal diameter (BPD), femur length (FL) and abdominal circumference (AC) in a patient who received TPN because of chronic malnutrition. BPD and FL were within normal limits before and after TPN. Consistent with asymmetric growth retardation, the AC was low prior to TPN and increased significantly after TPN was administered. Estimated fetal weight increased accordingly. These data suggest that TPN can reverse subnormal fetal growth secondary to maternal nutritional deprivation.

Adult↗
PubMed1986

Lipomyelomeningocele: prenatal diagnosis and management.

Spina bifida is one of the many congenital malformations possibly detectable in utero with ultrasound. Prenatal diagnosis can be useful in planning prompt, appropriate neonatal care of the infant. Lipomyelomeningocele (lipomyeloschisis) is a common subtype of spinal dysraphism. Prognosis for the infant with this skin-covered lesion is very good if appropriate care is provided early. Neonatal resection of these congenital lipomatous tumors is necessary to prevent tethering of the spinal cord that might lead to irreversible neurologic damage if not released. The prenatal ultrasonic appearance of lipomyelomeningocele is illustrated and the clinical presentation, implications, and neonatal neurosurgical care are reviewed.

Adult↗
PubMed1986

Pre- and postnatal ultrasonographic diagnosis of congenital obstructive uropathies.

Ultrasonography has proved particularly effective in evaluating the neonate with an abdominal mass, poor renal function, and an abnormal perinatal ultrasound scan. As a noninvasive, nonionizing, and relatively inexpensive examination, it can often make the preliminary diagnosis, streamline the work-up, and be used for follow-up studies.

Female↗
PubMed1986

Congenital obstructive uropathies. Pre- and postnatal treatment.

The evolution of sonographic techniques that allow accurate prenatal diagnosis of obstructive uropathies has led to consideration of specific therapeutic options in the care of such lesions. After briefly reviewing historical developments, the authors examine recent clinical experience with the prenatal treatment of congenital obstructive uropathies and consider possible clinical criteria for selecting appropriate candidates for such interventions.

Animals↗
PubMed1986

Results of treatment of severe fetal hydrothorax with bilateral pleuroamniotic catheters.

Unusual antenatal treatment of a case of severe fetal hydrothorax with secondary polyhydramnios and preterm labor is presented and illustrated. Bilateral pleural drainage catheters were placed antenatally to decompress the fetal chest in an effort to prolong pregnancy because of immature pulmonary studies and poor prognosis. Catheter migration occurred and effective drainage ceased after three days, but with tocolysis and bilateral thoracentesis, delivery was delayed another 48 hours to allow steroid therapy. With ventilatory therapy and chest drainage the infant survived and is doing well at one year of age.

Adult↗
PubMed1985

Prenatal detection of intraamniotic bands: implications and management.

The prenatal diagnosis of intraamniotic bands with confirmation at delivery is presented, and the pertinent literature is reviewed. The significance of intrauterine membranes or bands detected during pregnancy is not known. Direct fetal involvement by these structures has been reported in only one instance, but malformations apparently unrelated to amniotic bands have been common among reported cases. Serial ultrasound examinations are recommended both to exclude pseudosac, extrachorionic hemorrhage, blighted twin, and other possible causes of membranous structures and to search for fetal abnormalities.

Adult↗