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Biomedical subjects

R C Cefalo

Publications and source records attributed to R C Cefalo.

At least 91 records · Page 5Linked to original sources
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↗
PubMed1983

Maternal and fetal prostaglandins during acute fetal acidosis.

Prostaglandins have been detected in high levels in the fetal circulation. These substances are known to cause marked changes in the fetal and uterine circulations. The present study demonstrated an increase in fetal and maternal circulating levels of i prostaglandin F2 alpha in fetal lambs with acute acidosis. Both levels correlated with the degree of fetal acidosis. No consistent change in levels of i PGE were noted. Prostaglandins may play a role in the pathogenesis of response to fetal stress.

Acidosis↗
PubMed1983

Perinatal management of conjoined twins.

Thorough evaluation of all twin pregnancies is necessary if prenatal diagnosis of conjoined twins is to be made more often. Application of sonography, amniography, and amniocentesis is helpful in formulating prognosis, details of delivery, and subsequent assessment. Two-dimensional echocardiography, radionuclide scanning, computed tomography, and sonography are recently developed techniques for evaluation of the neonates. Detailed planning at all stages of care is essential. Interaction among medical personnel and the family is extremely important.

Abnormalities, Multiple↗
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

Pseudotumor cerebri in pregnancy.

Pseudotumor cerebri is an enigmatic neurologic disorder markedly more common in women of childbearing age. Diagnosis, management, and pregnancy outcome of nine women with active disease are described. Pregnancy is not contraindicated in women with pseudotumor cerebri, and termination of pregnancy is seldom required.

Adult↗
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

The influence of asphyxia on fetal lidocaine toxicity.

Local anesthetics have played an important role in modern obstetrics. Although reasonably safe, these agents have been shown to have detrimental effects in some fetuses. In the present study we examined the influence of acute asphyxia in the fetal lamb on the distribution and cerebral uptake of maternally infused lidocaine. Results demonstrate that asphyxia is associated with higher lidocaine concentrations in the fetal plasma, increased presentation of the drug to the fetal brain, and increased cerebral lidocaine uptake. These findings underscore the importance of evaluation of fetal status when considering the risks and benefits of maternal drug use.

Animals↗
PubMed1982

Malpresentations.

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Breech Presentation↗