Search PubMed⌕ Search

Biomedical subjects

S Mashiach

Publications and source records attributed to S Mashiach.

At least 235 records · Page 13Linked to original sources
PubMed1991

Meteorological factors in hypertensive disorders, vaginal bleeding and premature rupture of membranes during pregnancy.

In order to determine whether there is a correlation between meteorological factors and the occurrence of hypertensive disorders, vaginal bleeding during pregnancy and premature rupture of the fetal membranes, we stratified all the patients hospitalized with such complications between the years 1984 and 1988 by the months of occurrence, weather, humidity and heat. During this period, there were 276 women hospitalized with exacerbation of hypertension and toxemia, 349 because of vaginal bleeding during pregnancy and 35 women following premature rupture of the fetal membrane between 30 and 33 weeks of gestation. The occurrence of pre-eclampsia and exacerbation of pregnancy-induced hypertension was significantly increased in the winter months (p less than 0.001).

Female↗
PubMed1991

A simple scoring system for the treatment of cervical incompetence diagnosed during the second trimester.

Twenty-four women with second-trimester cervical incompetence underwent emergency cerclage. The appropriateness of cervical cerclage was analyzed according to a scoring system (Cervical Incompetence Scale; CIS) which measures the degree of cervical effacement, cervical dilatation and protrusion of fetal membranes into the cervical canal. Patients with low CIS (0-3 points) were found to have a more favorable pregnancy outcome than patients with high-score cervical incompetence (5-8 points), i.e. fewer complications following the procedure, 33.3 and 87.5%, respectively, fewer pregnancy losses (22.2 and 75%, respectively) and a significantly prolonged postoperative pregnancy course (mean gestation 33.2 and 24.4 weeks at delivery, respectively). The chances of a successful pregnancy outcome were evaluated at 87.5%; the outcome was successful in patients with low CIS presenting with effacement of the uterine cervix of less than 50%, cervical dilatation of less than 1.5 cm and with fetal membranes remaining in the cervical canal. On the basis of these results, we conclude that the emergency cerclage operation in carefully selected patients with midtrimester cervical incompetence may improve the outcome of pregnancy. This selection is facilitated by the use of a new cervical incompetence scoring system described herein.

Emergencies↗
PubMed1991

Neonatal alloimmune thrombocytopenia in consecutive pregnancies.

Neonatal and antenatal alloimmune thrombocytopenia is caused by the placental passage of maternal antibodies directed against platelet-specific fetal antigens. This disease is analogous to Rhesus hemolytic disease of the newborn and may be complicated by intracranial hemorrhage. Following increased awareness to the disease, it is currently no longer considered to be rare. Recent advances in the utilization of percutaneous umbilical cord blood sampling has led to a dramatic change in both prenatal and intranatal management of affected fetuses. We present a sibship with four infants, three of them found to have alloimmune thrombocytopenia. The neonatal thrombocytopenia in the subsequent births was not shown to be more severe, as could have been expected from the pathophysiologically analogous Rh hemolytic disease of the newborn. The role of prenatal determination of platelet count, intrauterine treatment with immunoglobulins and platelet transfusions, and elective cesarean section, in preventing possible hemorrhagic complications in repeated pregnancies should be reconsidered, taking into account the natural history of this rare disorder.

Blood Platelets↗
PubMed1991

Oxytocin or saline injected intra-umbilically did not influence the third stage of labor.

The injection of varying volumes of normal saline solution, alone or with oxytocin, into the umbilical vein immediately after delivery was studied in 125 normal women delivered at term. Thirty seconds after cord clamping, either 20 ml (group 1, n = 25 women), 30 ml (group 2, n = 25) or 40 ml (group 3, n = 25) of normal saline solution alone, or oxytocin 10 units in 20 ml saline solution (group 4, n = 25) or oxytocin 10 units in 40 ml saline solution (group 5, n = 25) were injected into the umbilical vein 1 cm from the introitus just proximal to the umbilical clamp. The mean (+/- SD) duration of placental expulsion was similar in the five study groups. We conclude that neither the volume of the solution nor the oxytocin injected intra-umbilically has any effect on the duration of the third stage of normal labor.

Adult↗
PubMed1991

Endocrine and biological factors influencing implantation of human embryos following cryopreservation.

Several parameters affecting survival and implantation of frozen-thawed embryos were studied. Of 386 embryos frozen in dimethylsulfoxide (DMSO) or in 1,2 propanediol (PROH), the survival rate was 63.5% (245/386). Three different methods of cycle preparation were compared prior to thawed embryo replacement. The pregnancy rate was 16.1% (9/56) in spontaneous cycles; 11.4% (5/44) in an ovarian stimulation protocol; and 9.5% (4/42) with estrogen and progesterone substitutional therapy (p = NS). There was no difference in the estradiol/progesterone ratio among the three different protocols during the early luteal phase of the cycle, which may indicate that implantation of thawed embryos could be related to their developmental potential rather than to the endometrial environment. In the spontaneous cycles, when endometrium was synchronized or advanced to embryonic stage up to 32h, implantation rate was 29.2%.

Adult↗
PubMed1991

Curettage vs. nonsurgical management in women with early spontaneous abortions. The effect on fertility.

Among 114 women with early spontaneous abortions, low beta-human chorionic gonadotropin levels and no ultrasonographically demonstrable residual tissue in the uterine cavity, 68 underwent uterine curettage, and 46 were managed conservatively. No complications, such as bleeding or infection, were observed in either group, and the probability of conception, outcome of subsequent pregnancies and rate of subsequent abortions were similar. Curettage offers no advantage over conservative management in selected patients with early abortions.

Abortion, Spontaneous↗
PubMed1991

Hypocalciuria of preeclampsia is independent of parathyroid hormone level.

Hypocalciuria is a feature of preeclampsia. The roles of parathyroid hormone (PTH) and vitamin D 1,25(OH)2D3 (calcitriol) in its pathogenesis have not yet been determined. Fourteen preeclamptic women were compared with 12 women with chronic hypertension and 11 normotensives, all in the third trimester. Preeclamptics had the lowest urinary calcium excretion rate (62.1 +/- 32.8 mg/24 hours) compared with chronic hypertensive women (162.6 +/- 97.8 mg/24 hours) and normotensive controls (225.6 = 146.9 mg/24 hours) (P less than .05). Serum PTH was lowest in preeclamptics (9.8 +/- 5.5 pg/mL), in contrast to the chronic hypertensives (18.5 +/- 2.7 pg/mL) and normotensives (16.4 +/- 3.2 pg/mL) (P less than .005). Similarly, urinary cyclic adenosine monophosphate (cAMP) excretion was 2.9 +/- 1.4 mumol/24 hours in the preeclamptics, 5.1 +/- 1.7 mumol/24 hours in the chronic hypertensives, and 4.6 +/- 1.3 mumol/24 hours in the normotensive group (P less than .05). These data suggest that the mechanism of hypocalciuria in preeclampsia is independent of the PTH-calcitriol axis. Therefore, it is suggested that the hypocalciuria of preeclampsia is due to intrinsic renal tubular dysfunction.

Adult↗
PubMed1991

Heart rate as a predictor of first-trimester spontaneous abortion after ultrasound-proven viability.

To discover whether first-trimester spontaneous abortion can be predicted by embryonic heart rate (EHR), we performed a cross-sectional study during the first trimester of pregnancy using high-frequency transvaginal sonography combined with pulsed Doppler. Heart rate was measured in 603 embryos; of these, 580 continued beyond 13 weeks' gestation and 23 ended in first-trimester spontaneous abortion. Based on the continuing pregnancies, we constructed and compared EHR nomograms relating to gestational age, mean diameter of the gestational sac, and crown-rump length (CRL). Embryonic heart rate correlated best with CRL (r = 0.87), and the correlation was best described by a second-degree polynomial regression equation. The mean EHR increased progressively from 110 beats per minute (bpm) at CRL of 3-4 mm to 171-178 bpm at CRL 15-32 mm. At CRL greater than 32 mm, the EHR remained stable at a mean of 170 bpm. The EHRs of the 23 embryos that spontaneously aborted in the first trimester were evaluated according to these nomograms. In 15 cases, the EHR fell outside the 95% confidence interval for CRL (sensitivity 65%), but it was within normal limits in eight (false-negative rate 35%). In ten embryos for which pregnancy continued beyond 13 weeks, the EHR fell outside the 95% confidence interval (specificity 98%, false-positive rate 2%). Our findings suggest that EHR measurements in early pregnancy may be useful in the prediction of first-trimester spontaneous abortion after ultrasound-proven viability.

Abortion, Spontaneous↗
PubMed1991

Fetal lateral ventricle choroid plexus cysts: the dilemma of amniocentesis.

Although lateral ventricle choroid plexus cysts in the second-trimester fetus have been considered a benign developmental phenomenon of no clinical significance, an association with trisomy 18 has been suggested. We designed a prospective study to determine whether karyotype analysis is indicated when such cysts are encountered on prenatal sonogram. During a 20-month period, 5400 low-risk pregnant women were examined sonographically in the second trimester to evaluate the prevalence of fetal lateral ventricle choroid plexus cysts and the incidence of ultrasonographic anomalies associated with such cysts in fetuses with trisomy 18 referred from cytogenetic laboratories. Thirty cases of fetal lateral ventricle choroid plexus cysts (0.6%) were detected during the study period; 28 newborns were normal and two had trisomy 18. One of the affected infants had other associated ultrasonographic abnormalities suggesting aneuploidy, whereas no detectable abnormalities could be found in the other. Three other pregnant women were referred to us from the cytogenetics services because fetal karyotype revealed trisomy 18; in all three cases lateral ventricle choroid plexus cysts and other sonographic abnormalities were observed. In total, we scanned five fetuses with trisomy 18, of which all had lateral ventricle choroid plexus cysts and four had associated detectable anomalies. We could not find any association between cyst size, number, or laterality and trisomy 18. In addition to the five cases of trisomy 18 described, we found 33 other fetuses reported with trisomy 18 in the second trimester; of this total, 25 (66%) had lateral ventricle choroid plexus cysts and 30% had no other detectable abnormalities.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

Clinical, surgical and pathologic findings of adnexal torsion in pregnant and nonpregnant women.

A series of 101 patients with adnexal torsion during a 12 year period are reviewed. Twenty patients were pregnant at the time of diagnosis and underwent surgical treatment. Preoperatively, the correct diagnosis was not established in four pregnant patients and in 30 nonpregnant patients. An operation was usually delayed for more than 24 hours. Unwinding of the twisted adnexa, regardless of its appearance, was the main surgical procedure in both groups. The outcome of the pregnancies was favorable. The main histopathologic findings in both groups were cysts of the follicular or corpora lutea.

Adnexal Diseases↗
PubMed1991

The role of cervical cerclage in the management of uterine anomalies.

The effect of cervical cerclage on the survival rate of the fetus was studied in 86 pregnancies of women with congenital uterine anomalies and a random group of 106 pregnancies in women with normal shaped uteri. The uterine morphologic factors were determined in all by hysterosalpingography, and when necessary, hysteroscopy and laparoscopy were combined. The incidence of hysterosalpingography-proved cervical incompetence (23 per cent) was similar in both groups. Sixty-seven and 29 pregnancies were managed with cervical cerclage in each group, respectively. The fetal outcome was stratified by cervical incompetence and obstetric history. The percentage of viable newborns was significantly higher in women with malformed uteri who underwent cerclage (88 per cent) compared with those without cerclage (47 per cent). No statistically significant beneficial effect of cerclage was found for normal uteri, even when only those with a history of recurrent fetal loss were considered.

Female↗
PubMed1991

Uterine anomalies. A retrospective, matched-control study.

The obstetric risk associated with congenital uterine malformations was studied in a group of 67 women who had undergone hysterosalpingography (HSG) during an eight-year period. HSG was performed to investigate primary (21% of the cases) and secondary (19%) infertility (group 1) or recurrent early fetal loss (60%) (group 2). The study group was compared with a random control group of 130 patients with HSG-proven normal uteri, matched for the presenting symptom. Prematurity and intrauterine fetal death were found to be significantly more common (P less than .05) for women in group 1 with uterine anomalies. The mean birth weight for preterm infants (less than 37 weeks) was significantly lower (P less than .01) for women with malformed uteri. The incidence of antepartum bleeding during pregnancy (P less than .01), breech presentation and cesarean section (P less than .001) was significantly higher for the study group. Premature rupture of the membranes was diagnosed more frequently (P less than .05) only in group 1. Patients with congenital uterine anomalies are a high-risk obstetric group. Primary infertility may be a more common presenting complaint in women with uterine anomalies than previously recognized.

Abortion, Habitual↗
PubMed1991

Prediction of pregnancy-induced hypertension by a combination of rollover test and Doppler flow velocity measurement.

Following a rollover test performed in 306 nulliparous women in the 28th gestational week, Doppler flow velocity studies were conducted in all 34 women with positive rollover findings and in 67 women selected at random from those with negative findings. The mean systolic diastolic ratios in both the uterine and the umbilical arteries were significantly higher in women with positive rollover findings than in the control group. A review of the patients' medical records after delivery, indicated that this combined two-stage screening approach--a rollover test followed by a Doppler flow study--improved the predictive value and the sensitivity of the screening procedure from 35% and 39% respectively for the rollover test alone, to 56% and 50% with no decline in specificity. The sensitivity of the Doppler flow test as a single one among the 101 flow-studied women was higher--61%. However, broader studies are needed in order to establish its superiority as a single test for early prediction of pregnancy-induced hypertension.

Adult↗
PubMed1991

Pregnancy after myocardial infarction: are we playing safe?

The safety of pregnancy after myocardial infarction remains a significant dilemma for both the obstetrician and the cardiologist. Only 20 cases of pregnancy after myocardial infarction have been reported. To clarify this problem, we add our experience of four such cases in which conception occurred 9 months to 9 years after myocardial infarction with no previous consultation. Each woman had an uneventful pregnancy with no cardiac or obstetric complications related to the myocardial infarction. All patients were under the strict supervision of an obstetrician and a cardiologist during pregnancy in our conjoined antepartum-cardiologic clinic. The mode of delivery in all patients was related to the obstetric indications. Our experience and the accumulated experience in the literature demonstrate good prognosis for patients who conceive after myocardial infarction.

Adult↗
PubMed1990

Pregnancy potential of human oocytes--the effect of cryopreservation.

BACKGROUND: In vitro fertilization, sometimes involving the cryopreservation of human embryos, has become a routine procedure for the treatment of infertility. Even though there are embryos available for transfer in about 85 percent of the treatment cycles, the rate of pregnancy rarely exceeds 25 percent per cycle. We designed this study to investigate two questions: Does this high rate of failure result from inadequate technique, or does it simply reflect the maximal potential of a cohort of aspirated eggs to produce a pregnancy? And to what extent does cryopreservation affect the capacity for implantation of embryos? METHODS: The study was conducted among patients enrolled in an egg-donation program. Aspirated eggs from a given cohort were distributed to the donor herself and a few recipients. The recipients were prepared by a standard protocol of hormone replacement and were assigned at random to the transfer of either fresh or frozen and thawed embryos. The donors received only fresh embryos. RESULTS: Forty cycles of donation were studied. In 25 cycles (63 percent) pregnancy was established in the donor, in the recipient (or recipients), or in both. Of the fresh embryos that were transferred to the recipients, 24 percent were successfully implanted, as compared with only 7.7 percent of the frozen and thawed embryos (P less than 0.01). A pregnancy success rate of 37 percent per recipient cycle was observed in the recipients of fresh embryos, as compared with a rate of only 16 percent in those receiving frozen and thawed embryos (P less than 0.05). CONCLUSIONS: The majority of egg cohorts evidently possess the potential to produce a pregnancy, but cryopreservation of human embryos significantly reduces their capacity for implantation.

Adult↗