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Biomedical subjects

R J Benzie

Publications and source records attributed to R J Benzie.

At least 19 recordsLinked to original sources
PubMed1992

Prenatal demonstration of a cervical myelocystocele.

Myelocystocele is a rare spinal cord disorder and has not been described prenatally. We report a case in which prenatal ultrasound and magnetic resonance imaging (MRI) demonstrated a posterior cervical mass which was initially thought to be a meningocele or an atypical cystic hygroma. Surgery performed at 1 day of age showed this to be a myelocystocele. Therefore, the differential diagnosis of an extracranial cystic mass in the posterior cervical region should be expanded to include myelocystoceles.

Adult↗
PubMed1991

Fetal therapy.

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Clinical Protocols↗
PubMed1989

An appraisal of pelvic ultrasound: a survey of gynecologists.

The clinical role and perceived usefulness of gynecologic ultrasonography (US) were determined by a survey of the 74 active members of the Eastern Ontario Obstetrical and Gynecological Society using a mailed questionnaire. There were 58 gynecologist respondents, 30 of whom had completed the specialty training before 1977 (Group I) when diagnostic US became generally available locally, and 28 whose training ended in or after 1977 (Group II). In general both groups found pelvic US to be useful and were cognizant of some of its potential benefits. Group II respondents tended to rely more upon both obstetrical and gynecological US than those in Group I, whereas Group I respondents were less familiar with some of the pitfalls or limitations of US in gynecologic practice. This suggests that the development of clinical decision-making skills by obstetric-gynecologic residents is influenced by the availability of US during their training. It may be of benefit to address the subject of relevant pitfalls in US by continuing medical education.

Attitude of Health Personnel↗
PubMed1987

Maternal serum alpha-fetoprotein screening: report of a Canadian pilot project.

A pilot project of maternal serum alpha-fetoprotein (MSAFP) screening was carried out in Ontario from 1982 to 1985 to examine the feasibility and acceptability of screening a prenatal population for open fetal neural tube defects. A total of 8140 patients at low genetic risk were screened. Patient acceptance was excellent. Blood samples were taken at 16 to 18 weeks' gestation. If the MSAFP level was elevated, the assay was repeated and an ultrasound examination performed. Amniocentesis was offered to 67 women with unexplained persistently elevated levels. The outcome of pregnancy was known in 7473 patients (91.8%). Seven of nine known open fetal neural tube defects were detected. All were confirmed, and no unaffected fetuses were aborted on the basis of the screening results. The rates of perinatal death (6.7%), intrauterine growth retardation (11.7%) and prematurity (23.3%) were significantly higher among the patients with unexplained elevated MSAFP levels than among those with normal levels (p less than 0.001). Of 20 patients with unexplained low levels, 10 subsequently had spontaneous abortions and 10 gave birth to term appropriate-for-gestational-age infants. Seven of nine patients who gave birth to infants with autosomal trisomy had MSAFP values below the median. The findings indicate that MSAFP screening is feasible, accurate and acceptable in a low-risk area.

Abortion, Spontaneous↗
PubMed1987

Prenatal diagnosis and management of congenital defects of the anterior abdominal wall.

Between the years 1980 and 1985, 25 cases of anterior abdominal wall defects were identified within the University of Toronto Perinatal Complex. There were 17 cases of omphalocele and eight cases of gastroschisis. Associated anomalies were found in 71% of infants with omphalocele and 50% with gastroschisis. They were the major cause of neonatal death. Prematurity was the second most common cause of death. The neonatal death rate was 59% in omphalocele and 38% in gastroschisis; the prematurity rates were 53% and 50%, respectively. In omphalocele, there was a 47% cesarean section rate, with a 50% neonatal death rate. Vaginal delivery was associated with a 67% death rate. In gastroschisis, there was a 50% cesarean section rate, with a 50% neonatal death rate. Vaginal delivery was associated with a 25% death rate. There is no evidence that cesarean section offers improved neonatal survival.

Abdominal Muscles↗
PubMed1979

Antenatal genetic diagnosis: current status and future prospects.

The current status of antenatal genetic diagnosis is reviewed and the limitations of present techniques are discussed. It is suggested that multidisciplinary clinics are the most efficient means of providing this aspect of health care. Advances in cell culture techniques, in ultrasonography and in fetoscopy will extend the services available, and the impact of this will be felt by the community. Education of the medical profession and the public in this area is necessary so that informed decision-making can take place.

Abortion, Therapeutic↗
PubMed1979

Natural history of placenta previa ascertained by diagnostic ultrasound.

Placental localization by diagnostic ultrasound was performed at 16 to 18 weeks' gestation in 1,098 patients prior to amniocentesis for genetic indications. Placenta previa was diagnosed in 58 patients, 47 of whom went on to delivery uncomplicated by placenta previa. There were five patients with placenta previa at delivery, four of whom had third-trimester bleeding. One patient was diagnosed as having a normal placental implantation at midtrimester but placenta previa was demonstrated at delivery. The incidence of placenta previa at 16 to 18 weeks' was 5.3% and fell to 0.58% at delivery, indicating a 90% conversion rate. Thus the vast majority of cases of asymptomatic placenta previa remain so and convert before delivery. These patients should be observed with serial ultrasound at 6 to 8 week intervals until delivery or unequivocal conversion. No restriction in activity seems indicated unless the placenta previa persists beyond 30 weeks or becomes clinically manifest.

Adult↗
PubMed1979

Amniotic fluid lecithin/sphingomyelin ratio, palmitic acid, palmitic acid/stearic acid ratio, total cortisol, creatinine, and percentage of lipid-positive cells in assessment of fetal maturity and fetal pulmonary maturity: a comparison.

Lecithin/sphingomyelin (L/S) ratio, creatinine, percentage of lipid-positive cells, palmitic acid, palmitic acid/stearic acid (P/S) ratio, and total cortisol were analyzed as tests for fetal maturity and fetal pulmonary maturity in 164 samples of amniotic fluid from 121 patients. Fifty samples were taken within 72 hours of delivery. The best tests for fetal maturity (37 weeks) with differential percentages were L/S ratio, palmitic acid, and P/S ratio. In the assessment of fetal pulmonary maturity, we studied an additional 174 samples in which only L/S ratio, creatinine, and lipid-positive cells were analyzed. All tests showed a high predictive value of an immature (positive) result was much less for all six parameters; the three best tests were total cortisol (33%), lipid-positive cells (26%) and L/S ratio (14%).

Amniotic Fluid↗
PubMed1979

Ultrasonic assessment of the fetal spine before 20 weeks' gestation.

The ultrasonic appearance of the normal and abnormal fetal spine before 20 weeks' gestation was reviewed in 121 pregnances. A model was constructed to establish the mechanism of production in the various configurations seen. The relative roles of ultrasonography, alpha fetoprotein assay, and fetoscopy in the diagnosis of spina bifida are discussed.

Female↗
PubMed1977

Fetoscopy.

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Adult↗
PubMed1976

Amniotic fluid tests for fetal maturity in normal and abnormal pregnancies.

Amniotic fluid creatinine, percentage of lipid-positive cells, and L/S ratio were determined on 285 samples from normal pregnancies and 222 samples from abnormal pregnancy states (Rh isoimmunization, diabetes, hypertensive disorders, intrauterine growth retardation, and hydramnios). In normal pregnancy the coefficient of correlation between true gestational age and estimated period of gestation (EPG) based on the three parameters was 0.94, in Rh isoimmunization 0.77, in diabetes 0.67, and in hypertensive disorders 0.59. In intrauterine growth retardation both the L/S ratio and creatinine were depressed, the coefficient was 0.61, and the EPG was consistently less than the true gestational age. The mean L/S ratio in pre-eclampsia was slightly below the normal mean and in diabetes the mean L/S ratio was also depressed. In 150 samples taken within 48 hours of delivery L/S ratios were accurate in assessing fetal pulmonary maturity although there was a 20 per cent incidence over all of false-immature values. There were no false-mature values except in diabetes (2/9).

Amniotic Fluid↗