Biomedical subjects
Publications and source records attributed to M S Cardwell.
Bilateral renal agenesis is a common congenital defect, with an incidence of 1 per 3,000 births. Though prenatal diagnosis is possible with ultrasound examination, sonographic findings may be equivocal, making the management of such pregnancies difficult. I report three cases that represent the diversity of the condition, and discuss implications of management.
The twin-to-twin transfusion syndrome and severe cervical stenosis are two unusual complications of pregnancy. I have presented a case in which both complications were additive in their adverse effects on the pregnancy.
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Chorioangiomas of the placenta are found in approximately 1% of all pregnancies. In most cases the lesion is identified only on histologic examination of the placenta after delivery. Prenatal diagnosis of large lesions is possible with ultrasound. The occurrence of a large chorioangioma during pregnancy may lead to serious maternal and fetal complications. A case of a large chorioangioma was associated with polyhydramnios and diagnosed antenatally with ultrasound. Fetal compromise from pressure necrosis of the tumor on the normal placental tissue necessitated preterm delivery.
The acardiac twin is a rare consequence of monozygotic twinning and occurs in 1 per 35,000 deliveries. One percent of all monozygotic twins is affected. Prenatal diagnosis is possible with ultrasonography. Complications associated with the presence of an acardiac twin include sequelae from the twin-to-twin transfusion syndrome, polyhydramnios, dystocia, ruptured uterus and congestive heart failure in the normal twin. In utero fetal therapy is possible in some instances.
Obstetric complications of triplet pregnancies may make the delivery of extremely premature infants in these multiple gestations inevitable. To our knowledge, this case represents the first report of triplets delivered on three separate days, 16 days apart, using the technique of delayed interval delivery. One of the infants survived.
Spontaneous adrenal hemorrhage is rare during pregnancy. Most reported cases have been associated with preeclampsia-eclampsia, trauma or septicemia. A woman was treated for recurrent unilateral adrenal hemorrhage during pregnancy.
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Fetomaternal hemorrhage and abruptio placentae may occur concurrently. A prospective study was done to determine the incidence of fetomaternal hemorrhage in noncatastrophic cases of abruptio placentae consistent with sonographic findings. Significant fetomaternal hemorrhage was found in 75% of noncatastrophic cases. Implications of conservative management of abruptio placentae with fetomaternal hemorrhage are discussed.
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Polyhydramnios is a relatively common obstetrical complication. Major causes include maternal diabetes, chromosomal disorders, isoimmunologic disease, congenital abnormalities, multiple gestations, and idiopathic reasons. Perinatal morbidity and mortality is high and maternal complications are frequent. Successful management depends upon appropriate diagnostic evaluation. Prolongation of the pregnancy for further fetal maturation may be achieved with timely therapeutic amniocenteses.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.