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Biomedical subjects

J W Seeds

Publications and source records attributed to J W Seeds.

At least 73 records · Page 4Linked to original sources
PubMed1984

The relationship of intracranial infrared light absorbance to fetal oxygenation. I: Methodology.

Current clinical methods for assessing fetal oxygenation in labor are indirect and remain somewhat imperfect. Since infrared light passes through the cranium and infrared light absorbance by tissues has been shown in adult animals to vary with oxygenation, monitoring of infrared light absorbance may serve as the basis for a new, more direct technique for the assessment of fetal condition. Described here is the application of infrared reflectance spectrophotometry to a fetal sheep model and the precision of the relationship between fetal arterial or venous PO2 and infrared light absorbance at selected wavelengths. A very strong, linear correlation (r = 0.915) was found between fetal arterial PO2 and intracranial infrared light absorbance according to an algorithm developed for selective monitoring of the state of hemoglobin oxygenation in tissue. With further development, this method holds promise for a more direct, noninvasive assessment of fetal condition in labor than is currently available.

Absorption↗
PubMed1984

Maternal and fetal effects of exchange transfusion with a red blood cell substitute.

Recent reports have demonstrated the efficacy of Fluosol-DA (20%) as a temporary erythrocyte substitute. We investigated two groups of pregnant ewes that underwent exchange transfusion. In group 1, the animals underwent a nearly total isovolemic exchange of Fluosol-DA (20%) for maternal whole blood; in group 2, the red blood cells were removed and the plasma along with Ringer's lactate was replaced isovolumetrically. Although group 1 animals received 100% oxygen and Fluosol-DA (20%), the maternal arterial P02 increased to 350 to 400 torr. However, the maternal blood oxygen content decreased during the exchange, with no change in fetal pH, Pco2, or hematocrit. Maternal blood pressure remained stable and there was a 40% to 50% increase in cardiac output and mean pulmonary arterial pressure. During the exchange, the maternal hematocrit decreased from a mean of 32% to 5.5%; the maternal fluorocrit at the end of the exchange was 9%. Throughout the Fluosol-DA (20%) exchange, the proportion of fetal brain oxyhemoglobin as estimated from infrared transcranial transmittance increased, as did the fetal blood P02 and oxygen content. In group 2, the maternal mean blood pressure decreased, and the hematocrit decreased from a mean of 32% to 8%. Despite an increase in the maternal P02 to 250 torr, the fetal P02 and oxygen content decreased in group 2. This investigation demonstrated that Fluosol-DA (20%) exchange of the mother does not impair delivery of oxygen to the fetus under the conditions of the study.

Animals↗
PubMed1984

Prenatal diagnosis of a severe deforming type of osteogenesis imperfecta.

A pregnancy at risk for a severe deforming type of osteogenesis imperfecta (OI) was monitored by ultrasonography and radiography. Long bone measurements were normal at 15 1/2 weeks gestation, but ultrasound detected an abnormality of one femur that appeared to be a fracture. The ultrasound study at 19 weeks revealed severe shortness of the femora, and radiographs showed only vertebral bodies with no other fetal skeletal parts clearly visible. These studies indicate the feasibility of prenatal diagnosis before 20 weeks for the more severe handicapping types of OI that are compatible with survival past the newborn period and that can result in death during later infancy.

Female↗
PubMed1984

Prenatal diagnosis of unilateral hydronephrosis with early postnatal reconstruction.

Real-time ultrasound systems, being used extensively now in obstetrical practice for fetal monitoring, are providing the urologist with more opportunities for early recognition and intervention of congenital hydronephrosis. Thorough postnatal investigation to confirm a diagnosis is advocated. An early postnatal surgical repair can be performed successfully.

Female↗
PubMed1984

Hydramnios and maternal renal failure: relief with fetal therapy.

Hydramnios and maternal renal compromise are described in a singleton pregnancy with a large fetal abdominal cystic mass. Both the hydramnios and the renal failure resolved after percutaneous drainage of the fetal cyst. Rapid reaccumulation of the mass resulted in redrainage and placement of an indwelling cyst/amniotic cavity diversion shunt. Successful continuous decompression and uneventful continuation of the pregnancy were observed for four weeks. The relationship between fetal abdominal masses and hydramnios is discussed.

Abdomen↗
PubMed1984

Recurrent idiopathic fetal hydrops: results of prenatal therapy.

A case of nonimmune hydrops recurring within a sibship is reported. Progressive severe fetal ascites and hydramnios at 31 weeks' gestation led to fetal paracentesis for both therapeutic and diagnostic purposes. A successfully placed indwelling peritoneal-amniotic diversion shunt functioned well but became dislodged, and rapid recurrence of ascites and hydramnios required two subsequent drainage procedures. Neonatal death occurred from pulmonary failure after delivery at 34 weeks' gestation, as had happened in the similarly affected sibling. Amniotic and fetal peritoneal pressures, biochemical analysis, and bacteriologic studies of fluid samples are reviewed. Although this experience adds to the knowledge of fluid dynamics in fetal ascites and hydramnios, it does not clearly support or refute such therapy in the care of fetal hydrops from nonimmunologic causes. Management issues are discussed.

Adult↗
PubMed1984

Anaesthesia for fetal surgery.

Anaesthesia for fetal surgery is described as used for thirteen procedures in seven patients. Analgesia was accomplished by local infiltration of lignocaine 1% by the surgeons and small incremental doses of intravenous medication by the anaesthetist as needed to make the mother comfortable and reduce fetal movement. There were no maternal or fetal complications. Ethical issues of this therapy are described.

Adult↗
PubMed1984

Impaired fetal growth: definition and clinical diagnosis.

Intrauterine growth retardation (IUGR) may affect up to 10% of pregnancies and results in substantially increased perinatal morbidity and mortality. Although many infants are small on a constitutional basis and not as a result of disease, many others suffer malnutrition from chronic progressive uteroplacental insufficiency. Genetic disease, embryonic infection, and various drug exposures may also result in IUGR. Inconsistency of diagnostic criteria has seriously hampered clinical research aimed at clarification of both the short- and long-term implications of IUGR. This part of the report examines both the significance and clinical definition of IUGR and reviews the diagnostic tests used for the detection of the problem of impaired fetal growth. The clinical approach to the management of IUGR is presented in the subsequent part of the report, which includes the ultrasonic evaluation and management of this entity.

Alcoholism↗
PubMed1984

Impaired fetal growth: ultrasonic evaluation and clinical management.

Although biparietal diameter has become the standard fetal dimension for dating purposes, it is accurate in the diagnosis of intrauterine growth retardation in only 50% of cases. Serial assessment of the abdominal circumference, on the other hand, may allow more accurate identification of impaired growth. The combined use of biparietal diameter and abdominal circumference in the estimation of fetal weight in utero directly addresses the basis of the diagnosis of impaired fetal growth. Ultrasonic observation of amniotic fluid volume, fetal muscle tone, and the texture of the placenta may also be valuable in the diagnosis of intrauterine growth retardation. Once a diagnosis of impaired fetal growth is made, the clinical management includes, possibly, treatment of maternal factors that may be contributing to the growth retardation and monitoring of fetal and maternal well being with delivery if serious deterioration of either mother or fetus is noted. Maximal safe retention in utero is the management goal, as long as some growth is noted and acute distress is not seen.

Amniotic Fluid↗
PubMed1983

Elevated maternal serum alpha-fetoprotein, second-trimester oligohydramnios, and pregnancy outcome.

Although the primary purpose of maternal serum alpha-fetoprotein (AFP) screening is to detect open neural tube defects, the technique is of value in the diagnosis of other fetal abnormalities. Six patients from the Alpha-Fetoprotein Screening Program, Perinatal Region IV, were found to have twice elevated maternal serum AFP levels associated with severe early second-trimester oligohydramnios. Five of the fetuses were found to have urinary tract abnormalities. The source of the elevated maternal serum AFP is not clear. Pregnancy prognosis appears poor. These cases should be thoroughly studied so that patients may be accurately informed of the recurrence risk.

Amniotic Fluid↗
PubMed1983

Ultrasonography in the antepartum diagnosis of conjoined twins. A report of two cases.

The advent of new and effective methods for the neonatal evaluation and treatment of conjoined twins has greatly increased the importance of prenatal diagnosis of this complication. Ultrasonography has become the method used most commonly to diagnose and evaluate multiple pregnancies. All ultrasonographers should be familiar with the signs associated with conjoined twins. We treated two patients in whom the antenatal diagnosis of conjoined twins was made by ultrasonography alone. One is the first reported case of the antenatal ultrasonographic diagnosis of conjoined twins in different presentations. The findings associated with conjoined twins are: (1) lack of a separating membrane, (2) inability to separate the fetal bodies, (3) presence of fetal anomalies, (4) identification of more than three vessels in a single umbilical cord, and (5) sonographic detection of any of the classic radiologic signs.

Adult↗
PubMed1983

Technique of early sonographic diagnosis of bilateral cleft lip and palate.

High-resolution real-time ultrasound equipment will lead to the evolution of techniques for the prenatal diagnosis of subtle fetal anomalies not seen before. A technique for the diagnosis of bilateral cleft lip and palate before 20 weeks' gestation with real-time ultrasound equipment is described and illustrated. Examination of the fetal face in the frontal and coronal planes should allow the diagnosis of severe clefting at an early gestational age.

Adult↗
PubMed1983

Obstetric care of the affected carrier of hemophilia B.

Hemophilia B (factor IX deficiency) is an X-linked recessive clotting disorder similar to hemophilia A. In both diseases, phenotypic expression of the disorder may occur in significant numbers of heterozygous carriers. This is presumably due to random inactivation of one of the two X chromosomes of the female carrier as described by the Lyon hypothesis. Described herein is the obstetric care of a severely affected heterozygous carrier of hemophilia B. Predelivery automated plasma exchange was used to raise factor IX levels successfully. Commercial factor concentrates were avoided. The Lyon hypothesis is discussed in detail, and recommendations are made for the care of the clotting factor-deficient gravid woman.

Adult↗
PubMed1982

Amniotic band syndrome.

The amniotic band syndrome is a collection of fetal malformations associated with fibrous bands that appear to entangle or entrap various fetal parts in utero, leading to deformation, malformation, or disruption. This syndrome is given many names yet follows a clearly defined clinical pattern. Misdiagnosis and inappropriate family counseling are chronic features. This article reviews the clinical features of the amniotic band syndrome, its epidemiology, and the status of prenatal and neonatal diagnosis. The spectrum of malformations associated with amniotic bands is summarized and illustrated. Major etiologic theories are examined. It is recommended that the clinician involved in the delivery of any infant manifesting elements of this unusual combination of defects seek specialized consultation in the pursuit of an accurate and precise diagnosis and appropriate genetic counseling.

Amniotic Band Syndrome↗
PubMed1982

Malpresentations.

Explore the source record for details and available documents.

Breech Presentation↗