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R Terinde

Publications and source records attributed to R Terinde.

At least 55 records · Page 3Linked to original sources
PubMed1992

[Evaluation of the pulsatile curve of the placental blood flow profile by polynomial analysis].

The analysis of uterine and umbilical blood flow velocities using A/B ratio, resistance index and pulsatility index has shown to be a highly specific and sufficiently sensitive method in the evaluation of high risk pregnancies. In situations of high peripheral vascular resistance diastolic velocities are low and index values are high. Additional information of flow velocities curves, as diastolic notching, is not represented in the indices commonly used. A mathematical model was established using polynom analysis of blood flow velocity curves. In a group of 78 patients with intrauterine growth retardation polynome analysis of uteroplacental flow velocity curves was more sensitive than resistance index and pulsatility index.

Blood Flow Velocity↗
PubMed1992

[Obstetric cw-Doppler--results of a study of normal values. Effect of different variables on results].

Using a 4 MHz continuous wave Doppler device reference values for resistance index (RI) and pulsatility index (PI) of uterine and arcuate arteries as well as umbilical artery were established based on 510 patients with uneventful pregnancies and deliveries. Percentiles are more suitable localisation gauge than are standard deviations. Neither RI nor PI of maternal arteries proved to be dependent on gestational age in the observation period. If the heart rate are in physiological ranges no clinically relevant effect on the results were observed in either the maternal of the foetal copartment. By contrast umbilical artery shows a definite linear relation between the indices measured and gestational age. A significant effect of placental site on the measurement was found in both, uterine and arcurate arteries, but only the differences found in arcuates were of clinical value. An increase of diastolic notching was observed in both, uterine and arcuate arteries during pregnancy. Mostly only one vessel showed diastolic notching when observed in normal pregnancy. With a lateralized placenta the condition was more probable on the contralateral site.

Blood Flow Velocity↗
PubMed1991

Uncommon chromosomal mosaicism in chorionic villi.

Three cases of unusual chromosomal mosaicism are reported for which the cytogenetic data show inconsistent findings between CVS and AC or fetal tissue, and which cannot be explained simply by non-disjunction. For case 1, in CVS the karyotype was 46,XY, whereas lymphocytes and fibroblasts revealed 69,XXY. DNA fingerprinting indicated one paternal and two maternal chromosome sets, the latter most probably due to omission of maternal meiosis II. For case 2, in CVS mos 46,XX/47,XX,+ mar de novo was observed. Amniotic fluid cells had the karyotype 46,XX. The origin of the marker chromosome might be explained by at least two events of unknown order (a somatic chromosome/chromatid deletion and non-disjunction of the homologous chromosome). In case 3 (CVS: mos 46,XY/46,XY,19q+ de novo; amniotic fluid cells, lymphocytes, and fibroblasts: 46,XY), the surplus of chromosome material in 19q+ might be explained on the basis of a somatic translocation. The idea of a chimera is less convincing, as the mosaic finding is restricted to one tissue. Furthermore, there was no hint of a vanishing twin. Hitherto, no case of structural chromosome mosaicism in CVS has been reconfirmed in fetal tissues.

Adult↗
PubMed1991

[Continuous-wave Doppler ultrasound in the 2d and 3d trimester of pregnancy--normal values].

Based on 427 patients with uneventful pregnancies and deliveries standard rates were established for the resistance index (RI) and the pulsatility index (PI) of the uterine, arcuate, and umbilical arteries. Percentiles, above all the 90th percentile, are more suitable localisation gauge than are standard deviations. In the observation period, i.e. from 18th to 42nd week of gestation, neither resistance nor pulsatility Index in the utero-placental compartment proved to be dependent on gestational age to any significant degree. By contrast, the umbilical artery showed a definite linear relation between the indices measured and gestational age. If the heart rates are in physiological ranges no clinically relevant effects of the heart rate on the measurement results were observed in either the maternal or the foetal compartment.

Blood Flow Velocity↗
PubMed1990

Umbilical cord haematoma as a complication of intrauterine intravascular blood transfusion.

Between October 1985 and February 1989, 49 ultrasound-guided intravascular fetal blood transfusions were performed in 16 patients (14 with rhesus (Rh) isoimmunization, 2 with non-immunologic hydrops fetalis (NIHF)). As an intra-operative complication, perivascular haematoma of the cord occurred in three patients (7 per cent). In two cases, fetal bradycardia necessitated delivery by Caesarean section at 30 and 32 weeks' gestation, respectively. In the third case, fetal bradycardia developed during transfusion, at 31 weeks' gestation, but normalized within 3 min. The baby was delivered as planned at 36 weeks of gestation, after another transfusion at 34 weeks. Dislodgement of the needle tip into perivascular tissue, caused by sudden fetal or maternal movements, is the reason for this complication. The haematoma develops as a result of delayed recognition and continuous transfusion into Wharton's jelly. Cord haematoma may be diagnosed in time by continuous ultrasound imaging, as illustrated in case 3. To minimize the risk of needle dislodgement during transfusion, sedation of the mother and complete immobilization of the fetus by injecting a short-acting muscle relaxant into the umbilical vessel are recommended.

Adult↗
PubMed1990

Intrauterine growth retardation associated with chromosomal aneuploidy confined to the placenta. Three observations: triple trisomy 6,21,22; trisomy 16; and trisomy 18.

Cytogenetic analysis in three pregnancies revealed chromosomal mosaicism confined to chorionic villi. They were ascertained in the third trimester by intrauterine growth retardation (IUGR) in otherwise normal fetuses. In case of triple trisomy 6,21,22 and trisomy 16, it was obvious that these findings were most likely restricted to the placenta. These trisomies act as early lethal factors when they occur in the embryo itself. With trisomy 18, however, the interpretation of the cytogenetic finding remains ambiguous. The question arises as to whether an abnormal karyotype may be the cause of placenta insufficiency or is just coincidentally associated.

Adult↗
PubMed1989

Doppler sonographic findings and their correlation with implantation in an in vitro fertilization program.

In 45 women from an in vitro fertilization (IVF) program, the uterine and ovarian blood flows were investigated by vaginal Doppler sonography. The resistance index was used to evaluate the blood pattern. When comparing the patients who became pregnant after embryo transfer (ET [group I, n = 12]) with those who did not conceive (group II, n = 33), it is evident that in group I the vascular resistance of the uterine arteries is significantly lower on the day of follicular aspiration. No differences could be detected in the ovarian vessels. The data obtained so far suggest that the receptivity of the endometrium is a crucial factor for successful implantation. In the final analysis, this can be appraised not only on the basis of morphological but also of hemodynamic parameters.

Embryo Implantation↗
PubMed1989

[Fetal kidney screening: growth curves and indices].

Kidney size was measured ultrasonographically in a cross-sectional study of 612 foetuses. Values of the length (Nlgs), width (Nqu), thickness (Nap) as well as cross-sectional area (Nqu-Fl) of the kidney were calculated by statistical means and correlated to gestational age. Because of the great biological variance, the ratio of kidney length and width to the thorax width and the ratio of kidney area to the thorax area, was calculated and the standard deviation was found to be very small. The ratios for growth-retarded and macrosomic foetuses from diabetic mothers were examined. The results are discussed and the syndromes, which is often associated with renal abnormality are tabulated.

Chromosome Aberrations↗
PubMed1989

Case of cyclopia with an unbalanced karyotype attributable to a balanced 3/7 translocation.

This report presents a case of cyclopia attributable to an unbalanced karyotype in a family with a balanced, reciprocal 3/7 translocation. This case was the fifth recorded in three generations of this family. From this report it is possible that the simultaneous action of partial trisomy 3p and partial monosomy 7q may be one cause of holoprosencephaly.

Abnormalities, Multiple↗
PubMed1989

[Ultrasonic monitoring of intravascular transfusion in severe Rhesus incompatibility. Diagnostic and therapeutic aspects after fetal relaxation].

Since October 1985 47 ultrasound-guided intrauterine intravascular transfusions were performed in 14 patients at the Department of Obstetrics and Gynecology of the University of Ulm. All newborns were delivered in good condition. The successful diagnostic and therapeutic management of severe erythroblastosis in a twin pregnancy is described. The twin with severe signs of erythroblastosis had an initial hematocrit of 12% at 26 weeks of gestation. Intravascular transfusion of 60 ml packed red cells raised the hematocrit to 41%. The ascites disappeared completely ten days after the first transfusion. Two further transfusions were performed at 29 and 33 weeks of gestation. The intrauterine intravascular relaxation with Norcuron (Vecuroniumbromid) has proved advantageous in preventing interfering fetal movement. Both newborns were delivered in good condition at 36 weeks of gestation.

Acute Disease↗
PubMed1989

Intrauterine treatment of severe fetal erythroblastosis: intravascular transfusion with ultrasonic guidance.

Twenty intrauterine, intravascular transfusion were performed in six patients under ultrasound guidance, the earliest one in the 19th week of gestation. In all twenty attempts we were able to insert the needle into the umbilical vein, transfuse between 12 and 80 ml of packed red blood cells, and raise the hematocrit (HK) up to 57% maximally. In two cases the fetal hydrops and the ascites completely disappeared. There was one complication in case 6. Fetal bradycardia developed after transfusion of 70 ml packed red cells in the 30th week. An immediate Caesarean sections was performed. The fetus was in a good condition and developed normally. All other fetuses were born by Caesarean section between 33 and 36 weeks of gestation and have had normal development up to now. These results show that the intrauterine, intravascular application of red blood cells is superior to the intraperitoneal approach. By the direct insertion into the cord the risk of fetal lacerations is minimal. On the other hand overtransfusion may occur more easily.

Adult↗
PubMed1988

[Experiences and successes with intravaginal fertilization and culture of human oocytes].

We present in this study our first experience with intravaginal culture (IVC) of human oocytes as a modified technique for in-vitro fertilization. Up to 4 oocytes and washed, pre-incubated spermatozoa (final concentration: 0.1-0.2 x 10(5)/ml) are pipetted into a plastic capsule. The capsule is closed, avoiding any air inclusion. It is placed into the maternal vagina for up to 50 hours, held in place by a diaphragm. The first 15 patients treated by IVC achieved a fertilization rate of 58% (35/60). Following transfer of the cleavage stages, 3 intact clinical pregnancies were established: 2 in the group with tubal sterility factors and 1 in the group of patients with endometriosis. In the group with andrological causes of sterility, one beta-hCG-positive reaction was detected. However, no intact clinical pregnancy was achieved. Our preliminary results show IVC to be a promising alternative in particular cases of sterility treatment. In contrast to the conventional technique, IVC minimizes exposure of gametes to factors which may affect their early development, such as light or low temperature. Furthermore, there is an important psychological factor to be considered, as the patient actively participates in the incubation period of in-vitro fertilization.

Embryo Transfer↗