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Biomedical subjects

M Mazor

Publications and source records attributed to M Mazor.

At least 253 records · Page 14Linked to original sources
PubMed1988

Intraamniotic infection and the onset of labor in preterm premature rupture of the membranes.

The purpose of this study was to examine the relationship between intraamniotic infection and the onset of labor in patients with preterm premature rupture of the membranes. Two hundred and thirty consecutive patients were admitted with premature rupture of the membranes to Yale-New Haven Hospital from January 1985 to July 1987. Amniotic fluid was retrieved by amniocentesis from 96% (221/230). Sixty-one patients were in labor on admission (27.6%, 61/221) and 39% of them (24/61) had a positive amniotic fluid culture. Patients in labor on admission were more likely to have a positive amniotic fluid culture than those who were not in labor on admission (24/61 versus 41/160, p = 0.049). Of the 160-patients who were not in labor on admission, 81 subsequently went into spontaneous labor; microbiologic information at the time of labor was known in 48 of these patients (59.2%). Seventy-five percent (36/48) of these patients had a positive amniotic fluid culture. The incidence of intraamniotic infection in quiescent women who subsequently went into labor was higher than that of patients admitted in active labor (75% versus 39%, p = 0.0004). These results provide a basis for the clinical impression that the onset of labor in women with preterm premature rupture of the membranes is associated with a subclinical intraamniotic infection. The mechanisms responsible for the onset of labor in women without an intraamniotic infection may be associated with an extraamniotic infection (e.g., deciduitis) or a noninfectious process.

Amniotic Fluid↗
PubMed1988

Fetal body and breathing movements as predictors of intraamniotic infection in preterm premature rupture of membranes.

A prospective study of fetal behavior in cases complicated with preterm premature rupture of membranes was conducted in 41 patients. The length of time and the number of fetal breathing and gross body movements were correlated with the amniotic fluid culture results. An episode of fetal activity (body movements and breathing movements) of greater than or equal to 30 seconds during 30 minutes of observation was associated with the absence of intraamniotic infection in 100% of the cases. On the other hand, the absence of fetal breathing movements and gross body movements of less than a 50 second duration during 30 minutes of observation was associated with positive amniotic fluid cultures in all cases. If an episode of fetal breathing movements was present but lasted less than 30 seconds and/or the total time of gross body movements was greater than 50 seconds, 64% of patients had an intraamniotic infection.

Amniocentesis↗
PubMed1988

The value of the leukocyte esterase test in diagnosing intra-amniotic infection.

This communication examines the diagnostic value of the leukocyte esterase activity (LEA) test in the detection of intra-amniotic infection. Amniotic fluid from 171 consecutive patients with premature rupture of membranes (n = 149) and preterm labor (n = 22) was obtained through amniocentesis. Gram stain, bacterial and mycoplasma cultures, and LEA tests were performed. The LEA had a sensitivity of 19%, a specificity of 86.7%, a positive predictive value (PPV) of 42.3% and a negative predictive value (NPV) of 67.6% in the prediction of a positive amniotic fluid culture (prevalence of positive cultures = 33.9%). The Gram stain had a sensitivity of 36.2%, specificity of 94.7%, PPV of 77.8%, and NPV of 74.3%. When both tests were combined, a significant increase in sensitivity to 50% was observed. This was associated with a drop in specificity to 81.4%. There was a correlation between the number of white blood cells in the amniotic fluid and the result of the LEA test. A positive LEA assay was associated with an increased likelihood of postpartum endometritis, but not with clinical chorioamnionitis or neonatal infectious morbidity.

Amniocentesis↗
PubMed1988

A critical appraisal of fetal acoustic stimulation as an antenatal test for fetal well-being.

Fetal acoustic stimulation is becoming a common modality for antepartum testing. The purpose of this study was to review the available literature on the subject to establish whether safety and efficacy have been determined. Safety could not be substantiated. The frequency, intensity, duration, and number of stimuli varied greatly among publications. There is no uniform nomenclature to score test results, and even the definition of the fetal acoustic stimulation test is not uniform. Data on the efficacy of the test are limited. Before fetal acoustic stimulation becomes part of standard obstetric care, rigorous clinical testing is required.

Acoustic Stimulation↗
PubMed1988

Reduction or cessation of fetal movements after administration of steroids for enhancement of lung maturation. I. Clinical evaluation.

Changes in fetal activity ranging from reduction to cessation of fetal movements were observed in patients at the 25th to 34th week of gestation, who were receiving steroids for enhancement of fetal lung maturation. This was a transient phenomenon, and fetal movements returned to normal by 24 h after the last injection of steroids. Concomitantly, during the period of exposure to steroids, we found an increased incidence of nonreactive monitoring patterns on daily analysis of fetal heart monitoring tracing. Although the pathophysiology of these changes is still unclear, we believe that the practical value of this observation is of importance. Reduction or cessation of fetal movements and a nonreactive nonstress test are generally accepted signs of fetal compromise and considered as an indication for termination of pregnancy. In this selective group of patients this is a temporary phenomenon; therefore, conservative management would seem in order.

Betamethasone↗
PubMed1988

The clinical value of gas-liquid chromatography in the detection of intra-amniotic microbial invasion.

Short-chain organic acids are byproducts of bacterial metabolism, and their detection by gas-liquid chromatography (GLC) in amniotic fluid has been proposed as a rapid, sensitive, and specific method for the diagnosis of infection. This study was conducted to determine whether GLC analysis of amniotic fluid would be helpful in a population of women in whom the Gram stain examination was negative. Amniotic fluid was retrieved by transabdominal amniocentesis from three groups of patients. Group 1 (negative control) contained 14 women with term pregnancies without clinical and microbiologic evidence of infection of the amniotic cavity; group 2 (positive control) included 17 women with a positive Gram stain examination and culture of amniotic fluid; group 3 (study group) comprised 25 women at risk for intra-amniotic infection who had a negative Gram stain of amniotic fluid. None of the patients in group 1 and 16 of 17 patients (94.1%) in group 2 had pathologic short-chain organic acids in the amniotic fluid. Seven of the 25 patients in group 3 had a positive amniotic fluid culture and only two had an abnormal GLC pattern. Of the remaining 18 patients with negative amniotic fluid cultures, eight had abnormal GLC results. In group 3, the sensitivity of GLC was 28.5% and the specificity was 55.5%. Gas-liquid chromatographic analysis of amniotic fluid has limited clinical value in the prediction of amniotic fluid culture when the Gram stain examination is negative.

Amniocentesis↗
PubMed1987

Pregnancy complicated by Cushing's syndrome.

A case of Cushing's syndrome in pregnancy due to adrenal adenoma is described. Despite the poor prognosis and the fact that treatment was delayed until after delivery, a normal term infant was born and maternal outcome was good.

Adenoma↗
PubMed1987

Abortion caused by electrical current.

A case of electrical accident in a pregnant woman at 9 weeks of gestation is described. No fetal heart activity was noted immediately after the injury, and spontaneous abortion occurred two days later.

Abortion, Spontaneous↗
PubMed1986

Management and outcome of vertex-breech and vertex-vertex presentation in twin gestation: a comparative study.

A comparative study of twin pregnancies with vertex-breech and vertex-vertex presentation was undertaken to evaluate the effect of mode of delivery on perinatal outcome. During the years 1978-1984 there were 89 cases of vertex-breech deliveries at our institution and a control group of 89 cases of vertex-vertex presentation were chosen. The cesarean section rate was 11.2% for both twins in vertex-breech, and 20.2% for the first twin and 23.6% for the second in vertex-vertex presentation. The primary indications for cesarean section were not related to the type of presentation. The perinatal mortality was 22.4/1000 in the study group and 89.8/1000 in the control population. There were no statistically significant differences in 5-min Apgar scores and perinatal morbidity between the two types of presentation. We found that the high perinatal morbidity and mortality of both twins is related to prematurity and intrauterine growth retardation and not associated with the type of presentation of the second twin. Therefore, routine cesarean section for vertex-breech presentation is not necessarily indicated.

Apgar Score↗
PubMed1986

Electrical accidents during pregnancy.

Electrical accidents during pregnancy are relatively infrequent, and reports are rare. Six pregnant women who suffered an electrical injury during pregnancy are presented here. For all, the current path through the body was from hand to foot. Changes that occurred in fetal movements and development as well as the outcome of the pregnancies, are presented. After delivery, the placenta and cord were carefully examined in all cases. From an analysis of the published cases and the present findings, it seems that there are no specific clinical and pathological signs of fetoplacental damage. Medical examination, shortly after the accident, may reveal a dead fetus. However, when it is found alive, oligohydramnios or growth retardation may develop later, and a close follow-up seems advisable. Pregnant women should be warned to notify their attending physician in all cases of electrical shock, no matter how apparently minor.

Adult↗
PubMed1986

The effect of maternal hypocalcemia on fetal heart rate baseline variability.

Marked decrease in fetal heart rate variability during labor was observed in a term fetus, borne by a mother with severe hypocalcemia due to idiopathic hypoparathyroidism and nutritional vitamin D deficiency. During the period of decreased baseline variability, fetal scalp pH was normal. A marked increase in fetal heart rate variability was observed within 5 minutes of intravenous administration of 1 gram calcium gluconate to the parturient. It seems that the recognition of the effect of maternal hypocalcemia on baseline fetal heart rate variability is important for accurate interpretation of fetal monitor tracing.

Adult↗