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Biomedical subjects

L D Platt

Publications and source records attributed to L D Platt.

At least 181 records · Page 10Linked to original sources
PubMed1984

Use of amniocentesis in preterm gestation with ruptured membranes.

Sixty-one patients with preterm rupture of membranes were studied. Transabdominal amniocentesis was performed successfully in 42 patients (68.8%). Among these 42, 26 (61.9%) had a lecithin:sphingomyelin (L:S) ratio of 1.8 or greater and 16 (38.1%) demonstrated pulmonary immaturity. Amniotic fluid obtained from vaginal pooling was compared to fluid obtained transabdominally in seven patients and did not demonstrate any significant differences in L:S values. Gram stain and subsequent culturing of amniotic fluid obtained transabdominally was accomplished in 41 patients. Seven of the 41 patients (17.0%) had bacteria on Gram stain and/or subsequent amniotic fluid growth. All patients with either bacteria on Gram stain or a positive amniotic fluid culture developed clinical amnionitis or endometritis. Review of the neonatal morbidity and mortality in relation to gestational age of infants with preterm rupture of membranes suggests that: 1) In infants at less than 32 weeks' gestation, amniocentesis need not be done for pulmonary maturity as the morbidity of prematurity in this group is too high even in the presence of pulmonary maturity. 2) In infants at 32 to 34 weeks' gestation, amniocentesis for L:S ratio, Gram stain, and culture is helpful in selecting those in whom delivery should be instituted. 3) In infants at greater than 34 weeks' gestation, the neonatal morbidity is sufficiently reduced so that delivery should be considered except in cases of suspected delayed pulmonary maturation.

Amniocentesis↗
PubMed1983

Exercise in pregnancy. II. Fetal responses.

Healthy pregnant women underwent a mild exercise study to evaluate the effects of this amount of work on their fetuses. The results indicated that there were no direct correlations between exercise and fetal body or breathing movements at this particular work intensity (2.33 m). We found a relationship between the maternal sympathetic activity as reflected in epinephrine levels and the degree of fetal activity.

Adult↗
PubMed1983

Fetal echocardiography. III. The diagnosis of cardiac arrhythmias using real-time-directed M-mode ultrasound.

A technique that makes use of real-time-directed M-mode echocardiography is described in which the fetal heart is evaluated for suspected cardiac arrhythmias. Simultaneous M-mode recording of aortic, mitral, or tricuspid valvular leaflet excursion and/or atrioventricular wall motion defines timing relationships between atrial and ventricular systole. With the use of the techniques described in this report, normal as well as abnormal atrioventricular contractions can be quantitated and cardiac arrhythmias accurately defined.

Arrhythmias, Cardiac↗
PubMed1983

The ultrasonic appearance of intravascular gas in fetal death.

Real-time ultrasonography permits an accurate diagnosis of intrauterine fetal death by documenting absent cardiac motion. Occasionally, intravascular and/or intracardiac gas arises from maceration following fetal demise. The presence of gas in the heart and circulatory system alters the ultrasonic appearance of the fetal body. What may appear to be technically poor visualization of the fetus secondary to tissue maceration, oligohydramnios, or maternal factors may, in fact, be due to reverberation artifacts produced by intravascular gas. These characteristic echogenic foci have been radiographically proven to represent intrafetal gas. Recognition of the appearance of gas in the circulatory system is important since gas is a pathognomonic sign of fetal death.

Adult↗
PubMed1983

Further experience with the fetal biophysical profile.

At Los Angeles County/University of Southern California Medical Center, the authors performed biophysical profile testing on 186 fetuses within one week of delivery. One component of the biophysical profile is the nonstress test. The other four components are fetal parameters observed with real-time ultrasonography: fetal breathing movements, fetal movements, fetal tone, and amniotic fluid volume. Clinicians managed the patients on the basis of the nonstress test result, and the authors did not report the other biophysical profile results. Measures of outcome included perinatal mortality, fetal distress in labor, low five-minute Apgar score, and birth weight small for gestational age. Results indicate that fetal biophysical parameters other than the response, or lack of response, of the fetal heart rate to fetal movements may have predictive value in assessing the state of fetal health. In the future, real-time ultrasonography may prove to be a reliable adjunct to antepartum electronic fetal heart rate monitoring.

Amniotic Fluid↗
PubMed1983

Tyrosine supplementation during pregnancy in a woman with classical phenylketonuria. A case report.

A woman with classical phenylketonuria (PKU) adhered poorly to a phenylalanine-restricted diet but did receive tyrosine supplementation from the 14th week of gestation until delivery. At birth the infant demonstrated a head circumference more than two standard deviations below the mean but at 2 years of age had a development quotient (DQ) of 94. This case illustrates the fact that while single case reports may be of value in disproving a theory, they are not sufficient to prove an association because biologic variation may explain one's results. Thus, while tyrosine supplementation may explain the relatively normal DQ, the results are also compatible with the moderate degree of phenylalanine restriction obtained. Current evidence favors the elevated maternal phenylalanine level as the cause of defects in offspring of women with PKU, but tyrosine supplementation should be considered if the level is subnormal.

Female↗
PubMed1982

The use of ultrasound in the prediction of fetal pulmonary maturity.

Previous studies suggest that ultrasound criteria of biparietal diameter (BPD) and/or placental grade permit elimination of amniocentesis for pregnancy dating. To evaluate the potential risks and benefits of such a modified approach to determining fetal maturity, this prospective study, in which a BPD of greater than or equal to 9.2 cm or a Grade III placenta was used instead of amniotic fluid analysis, was undertaken. One hundred fifty-three infants were delivered electively between March, 1981, and January, 1982, on the basis of ultrasound parameters of pulmonary maturity. None of the electively delivered infants developed respiratory distress syndrome. We conclude from these preliminary results that the ultrasonically determined BPD of greater than or equal to 9.2 cm Grade III placenta is at least as sensitive as the lecithin/sphingomyelin ratio in predicting pulmonary maturity in our patient population.

Cesarean Section↗
PubMed1982

Fetal echocardiography. II. The diagnosis and significance of a pericardial effusion in the fetus using real-time--directed M-mode ultrasound.

By means of real-time--directed M-mode ultrasound, the hearts of normal and abnormal fetuses were evaluated for evidence of a pericardial effusion. Because of its limited potential space, the pericardial sac appears to become distended with fluid prior to ultrasound evidence of ascites, pleural effusions, or soft tissue edema. Fetal echocardiography, therefore, appears to be useful in the assessment of fetuses at risk for developing hydrops.

Adult↗