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Biomedical subjects

M Feingold

Publications and source records attributed to M Feingold.

At least 109 records · Page 6Linked to original sources

Obstetric diagnosis and perinatal mortality.

A multidisciplinary team composed of obstetricians, pediatricians, and pathologists examined the causes of 453 consecutive perinatal deaths, which occurred between 1978 to 1982. A clear distinction between obstetric diagnosis and infant cause of death was made, and a prinicpal obstetric and infant diagnosis was assigned to each death. Perinatal death rates by obstetric category were calculated. The rates varied from 6.1 per 1000 births in uncomplicated cases to 217.4 per 1000 births in isolated intrauterine growth retardation. The causes of perinatal death within obstetric categories were tabulated. Nonviability or the complications of prematurity (65%) were the leading causes of death when there was third-trimester bleeding, premature labor, or premature rupture of membranes. Anoxia (59%) was the most frequent cause of death when there was hypertension/pre-eclampsia or other uteroplacental insufficiency states. Death from congenital abnormality accounted for 17.7% of all perinatal deaths. A focus on the causes of perinatal death with obstetric diagnostic categories helps weigh the risk of prematurity versus the risk of anoxia in the management of high-risk gravidas.

Boston↗

Serial amniocenteses in the treatment of twin to twin transfusion complicated with acute polyhydramnios.

Twin to twin transfusion, complicated by acute polyhydramnios in a monozygous twin pregnancy, is a difficult clinical problem. A precipitous course usually results in termination of the pregnancy within a few days and often is associated with a high perinatal mortality rate. Two cases are presented that were treated with repeated amniocenteses for the relief of extreme abdominal discomfort and to prevent imminent premature labor. The amount of amniotic fluid removed each time varied from 300 cc to 1200 cc, which was enough to relieve symptoms but not enough to induce uncontrolled uterine activity. A total of 3500 cc and 4750 cc of amniotic fluid were removed from the first and the second patient, respectively. The procedure was found to be safe and resulted in prolonging the pregnancies by 14 and 11 days, respectively. This management, with the addition of tocolysis and close fetal surveillance can offer some hope in an otherwise hopeless situation.

Adult↗

Acute polyhydramnios complicating monozygous twin pregnancies--case report.

Two cases of acute polyhydramnios complicating twin pregnancies were treated with repeated amniocentesis for the relief of extreme abdominal discomfort and to prevent imminent premature labor. The procedure was found to be safe and resulted in prolonging the pregnancies by 14 to 11 days respectively. This management, with the addition of tocolysis and close fetal surveillance (which resulted in 2/4 living children) can offer some hope in an otherwise hopeless situation.

Adult↗

Kernicterus.

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Humans↗

Pityriasis alba.

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Adolescent↗

Effect of mode of delivery on morbidity and mortality of infants at early gestational age.

The effect of mode of delivery on the mortality and morbidity of 26- to 32-week neonates was studied. Five hundred six consecutive deliveries at 26 to 32 weeks' gestation were reviewed. The populations were divided into high-risk and low-risk neonates by evaluation of antepartum variables known to increase neonatal risk, ie, abruptio placenta. One hundred ninety-six infants were classified as low risk. In this group, 124 vaginal and 72 cesarean section deliveries were compared using demographic, peripartum, and neonatal variables. Cesarean delivery was associated with highly significant maternal morbidity, including a 30% incidence of vertical uterine incision. No difference in neonatal mortality was shown. Cesarean delivery was associated with lower one-minute Apgar scores and a greater incidence and severity of hyaline membrane disease. No neonatal differences were shown in the incidence of trauma, intraventricular hemorrhage, or seizures. This study does not support cesarean delivery of all tiny neonates.

Apgar Score↗

Infection and phagocytosis as possible mechanisms of rupture in premature rupture of the membranes.

The concept that premature rupture of the membranes is due to an infectious process is well accepted. However, no definitive data implicating a particular microorganism or a mechanism of action have been advanced. By the use of our recently developed experimental in vitro amnion-chorion reaction vessel model we have studied the effect of the peroxidase-hydrogen peroxide-halide antimicrobial system on these membranes. We have noted that amnion, chorion, decidua, and placental macrophages all possess peroxidase activity. Tissues collected from deliveries following labor (vaginal) are significantly higher in activity than those collected from deliveries with no labor (cesarean section). A mobilization of enzyme from macrophages to amnion appears to occur in the laboring patient. Increased protein hydrolysis is noted in membranes collected from patients without labor subjected to the peroxidase-hydrogen peroxide-halide cytotoxic system when compared with membranes from laboring patients. Bursting pressures of membranes collected from patients without labor are shown to be decreased when the membranes were incubated in the presence of lysolecithin or in the presence of amniotic fluid and phospholipase A2.

Amnion↗

Incontinentia pigmenti. A longitudinal study.

We describe 15 patients with incontinentia pigmenti whom we have followed up from two to 11 years. This longitudinal approach allowed us to observe the course of the skin lesions and developmental progress of these children. We found that in contrast to what has been previously reported in most of the literature, the bullous and verrucous lesions do not always resolve during the first or second year of life and may recur throughout childhood. Although most patients with incontinentia pigmenti are of normal intelligence, those with neonatal seizures have a poor prognosis for normal development.

Bone Diseases, Developmental↗

Fetal neuroblastoma and catecholamine-induced maternal hypertension.

A case of congenital neuroblastoma is presented. The interesting features are maternal symptomatology consistent with fetal production of catecholamines and the dilemmas of differential diagnosis. Observations are made on the frequency and diagnosis of fetal neoplasia. Antepartum detection of catecholamine metabolites may be the basis for the diagnosis of fetal neuroblastoma.

Adult↗