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Biomedical subjects

R R Lenke

Publications and source records attributed to R R Lenke.

At least 37 records · Page 2Linked to original sources
PubMed1989

In utero diagnosis of benign fetal macrocephaly.

Benign familial macrocephaly is an autosomal dominant disorder associated with a large absolute circumference of the head. In this disorder serial growth demonstrates a proportional rather than an excessive rate of growth. To date, we are not aware of any published case reports that confirm the diagnosis prenatally. We report a case of benign familial macrocephaly diagnosed in utero by ultrasonographic evaluation. This case report points out the necessity of combining appropriate family history and physical examination in cases of prenatally detected anomalies.

Adult↗
PubMed1989

Elevated maternal serum alpha-fetoprotein values. How low is high?

Most maternal serum alpha-fetoprotein (MSAFP) screening programs are set up with the goal of prenatal detection of fetal neural tube defects. It is also commonly accepted that MSAFP testing yields many false-positive results. Screening programs commonly utilize schemata that identify abnormal levels of MSAFP as greater than 2.5 multiples of the median (MOM) and also recommend two abnormal values before initiating ultrasound evaluation. Our pilot program evaluating obstetric outcomes found that 21 of the 29 women with elevated MSAFP values (greater than 2.0 MOM) eventually developed significant pregnancy management changes or complications of pregnancy. Thus, we believe that the use of MSAFP screening solely for the purpose of detecting fetal neural tube defects is inconsequential relative to its usefulness in detecting other pregnancy abnormalities. We also believe that ultrasound evaluation should be accomplished after the first abnormal value and that the cutoff of 2.5 MOM should be lowered to at least 2.0.

Adult↗
PubMed1988

Maternal urinary bladder filling for middle and late trimester ultrasound. Is it really necessary?

A retrospective study was conducted to determine if there was a correlation between maternal urinary bladder filling and the ability to obtain fetal measurements. The ultrasonographic examinations of 400 randomly selected second and third trimester patients were evaluated. The patients examined either had a full bladder or an empty bladder. Although all patients were considered to have adequate examinations, 91.5% of those with a full bladder and 93% of those with an empty bladder had complete (four parameter) biometric evaluations. No statistical correlation was found between maternal bladder size and the ability to obtain fetal measurements.

Female↗
PubMed1988

Antenatal diagnosis of Pena-Shokeir syndrome (type I) with ultrasonography and magnetic resonance imaging.

A case of Pena-Shokeir syndrome type I was diagnosed prenatally with ultrasonography and magnetic resonance imaging (MRI) in a woman with a possible previous occurrence. Initial ultrasonographic examination at 18.5 weeks' gestation demonstrated an unusual appearance of the fetal spine in an otherwise unremarkable fetus. However, subsequent sonographic examinations at 26 and 28.5 weeks demonstrated polyhydramnios and multiple skeletal, brain, and facial abnormalities. Magnetic resonance imaging, performed to further evaluate the fetal brain, confirmed the sonographic findings. However, MRI was not useful in further differentiating the diagnosis. A 1024-g, premature male fetus was delivered at 30 weeks' gestation and died within 30 minutes of delivery. The fetus had multiple congenital anomalies consistent with Pena-Shokeir syndrome type I.

Abnormalities, Multiple↗
PubMed1987

Pyelonephritis in pregnancy. The role of in-hospital management and nitrofurantoin suppression.

Acute pyelonephritis remains a frequent complication of pregnancy. Prevention of the potential complications of this disease requires aggressive in-hospital management. However, the high frequency of positive outpatient cultures following discharge has cast doubt on the adequacy of in-hospital care and, at the same time, has concentrated attention on follow-up care. In a randomized, prospective study, we evaluated the effects of in-hospital management and outpatient nitrofurantoin on subsequent urine cultures. The overall frequency of positive cultures following discharge from the hospital was 38%. However, appropriate antibiotic selection, a negative follow-up in-hospital culture and nitrofurantoin suppression reduced the rate to 8% (P less than .01). Nitrofurantoin did not reduce the rate of positive cultures if antibiotic selection was inappropriate or if the in-hospital follow-up culture was positive. These results suggest that more aggressive management of acute pyelonephritis in pregnancy may be indicated and that suppressive therapy cannot compensate for inappropriate in-hospital management.

Adult↗
PubMed1986

Fetal gastroschisis: a preliminary report advocating the use of cesarean section.

Twenty-four cases of fetal gastroschisis referred between 1982 and 1984 were evaluated. The seven infants delivered by cesarean section all had primary closures and an average hospital stay of 18 days. Of the 17 infants delivered via the vaginal route, there were three deaths; primary closure was only possible in 11 and the average hospital stay was significantly prolonged. Until a large multicenter, prospective randomized study can be accomplished, the present data support the use of cesarean section for delivery of infants with gastroschisis.

Abdominal Muscles↗
PubMed1986

Severe nonimmune fetal hydrops with fetal survival. A case report.

A case of severe idiopathic nonimmune fetal hydrops spontaneously resolved after delivery with only basic supportive therapy. This case emphasizes that natural occurrences occasionally are responsible for successes attributed to invasive intrauterine treatments.

Adult↗
PubMed1986

Computed tomographic pelvimetry.

Pelvimetry can be performed on a computed tomographic (CT) scanner using anteroposterior and lateral scanned projection radiographs (Scout View) plus a single CT slice through the low pelvis. This technique yields accurate measurements of the maternal pelvis that do not need compensation for magnification. The fetal lie and presentation can be easily assessed, along with the fetal neck for hyperextension. In addition, the total radiation dose to both mother and fetus is significantly lower than with routine plain film pelvimetry. Since the procedure is quick, easy to perform and competitive in cost, CT pelvimetry should be the procedure of choice in those rare instances in which pelvimetry is indicated.

Female↗