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Biomedical subjects

S Mashiach

Publications and source records attributed to S Mashiach.

At least 379 records · Page 21Linked to original sources

Uterine anomalies in diethylstilbestrol-exposed women with fertility disorders.

Uterine anomalies were demonstrated by hysterosalpingography (HSG) in 4 of 5 diethylstilbestrol (DES) exposed young women with fertility disturbances. The anomalies included malformed uterine cavities and cervical incompetence. It is suggested that HSG in DES exposed women with fertility disturbances be performed early in the process of infertility investigation and cerclage should be considered when uterine anomalies are demonstrated. Tubal pregnancy should be ruled out by ultrasonography early during pregnancy in DES-exposed women.

Abnormalities, Drug-Induced↗

Triplet pregnancy in uterus didelphys with delivery interval of 72 days.

A unique case of triplet pregnancy in a woman with uterus didelphys is described, with fetuses A and B in the right uterine horn and fetus C in the left horn. Missed abortion of fetus A was diagnosed in the 22nd week of gestation by real-time ultrasonography, but only in the 27th week of gestation did the right uterine horn contract, resulting in expulsion of fetus A. Fetus B was delivered by cesarean section 2 hours later. Fetus C remained in the left uterine horn until the 37th week of gestation, when a viable 2490-g female infant was delivered by cesarean section. Triplet pregnancy occurs with sufficient frequency to be unremarkable; however, triplet pregnancy in a patient with uterus didelphys and with 72 days' lapse between the delivery of the first 2 fetuses and delivery of the third is a rare occurrence.

Abortion, Missed↗

Cumulative conception rates following gonadotropin therapy.

During the years 1963 to 1978, 515 patients were treated with HMG. They were divided into two groups depending upon the absence (Group I) or presence (Group II) of distinct endogenous estrogen activity. Group II patients were referred after failure of clomiphene therapy. None of the patients had mechanical or male infertility factors. The cumulative pregnancy rate (life table method) in Group I patients after six cycles of treatment was 91.2%. In 77 patients from Group I, further treatment was given for a second pregnancy after the first gonadotropin conception. In this group, the cumulative conception rate was 93.6% after eight cycles of treatment. In Group II the cumulative conception rate was 50% after 12 cycles of treatment. In both groups, the results were better in patients who were less than 35 years of age than those who were 35 or more when treated.

Adult↗

Fetal common cloaca--a case report and review.

A case is presented in which a huge cystic mass adjacent to the outline of a 29-wk fetus was identified by ultrasonography. After delivery this was proven to be a common cloaca in a fetus with multiple congenital anomalies. The possible mechanisms of this anomaly are discussed.

Abnormalities, Multiple↗

Intra-amniotic thyroxine (T4) absorption by the premature human foetus.

We reported previously on the beneficial influence of intra-amniotic T4 injection in accelerating human foetal lung maturity. Twenty-four h after T4 (250 microgram) intra-amniotic injection, the mean cord serum T4 concentration in 13 premature newborns was 17 +/- 2.1 microgram/100 ml, while the T4 concentration in a matched group was only 11.6 +/- 0.9 microgram/100 ml: in 5 of the infants who received intra-amniotic thyroxine T4 was measured 12 h post-partum and rose from 16.1 +/- 1.8 to 24.3 +/- 2.6 microgram/100 ml. No change in maternal T4 concentration was observed. The mean cord serum T4 concentration in premature newborns delivered more than 3 days following T4 intra-amniotic injection, however, was not significantly different from that of the controls. These data suggest that T4 (250 microgram) injected intraamniotically is absorbed by the premature human foetus. Furthermore, the hyperthyroxinaemia is only transient, and does not prevent the post-natal T4 surge.

Absorption↗

Cell mediated and local immunity to spermatozoa in infertility.

The possibility of the immunological factor as an etiological cause of infertility was investigated in 50 infertile couples. Of these, 31 couples were considered as an "unexplained sterility" group, while in the other 19 couples a variety of disorders were diagnosed. In vitro, leucocyte migration inhibition test (LMIT) was used for the detection of female cell-mediated immunity against sperm antigens. Sperm immobilization test (SIT) and sperm toxicity tests (STT) were used for the detection of antisperm antibodies in the cervical mucus. Out of the 31 "unexplained sterility" cases, six revealed a positive LMIT (5.3%). In 26 couples with an abnormal postcoital test (PCT), 10 cases had a positive SIT and STT (38.5%). However, out of the group of 16 couples with a normal PCT only in one case was a positive SIT and STT found (6.2%). The potential role of immunological reactions in infertility will be discussed.

Antibody Formation↗

Vasa previa: a major complication and its management.

Vasa previa is an extremely rare condition. Consequently it is not often considered in the differential diagnosis of antepartum or intrapartum hemorrhage. Rupture of a fetal vessel may lead to sudden fetal death from exsanguination; therefore, this condition should be suspected in any antepartum or intrapartum hemorrhage. The blood that is lost should be tested for the presence of fetal hemoglobin. Other diagnostic tests to assess the degree of fetal distress are described. Four patients showing unusual presentations of vasa previa are reported. These cases demonstrate that fetal vessel rupture may occur independently of membrane rupture.

Adult↗

Enhancement of fetal lung maturity by intra-amniotic administration of thyroid hormone.

Following preliminary results in animal studies demonstrating that thyroxine (T4) injected directly into the fetus or the amniotic sac is capable of enhancing fetal lung maturity, a trial of thyroxine treatment in mean was carried out. Two hundred micrograms of T4 were injected intra-amniotically in eight women with high-risk pregnancies in which premature delivery was inevitable or indicated. Fetal lung maturity was evaluated by a recently developed, accurate, and rapid method using the microviscosity value epsilon (this being the linear expression of the polarization value P) of the lipid assembly of the amniotic fluid as a parameter of the surfactant content. epsilon Values, which were very high before T4 injection, dropped steeply to below the value of 4.344, indicating fetal lung maturity. Eight newborn infants delivered, five by caesarean section, soon after the T4 injection did not develop respiratory distress syndrome, although they were born prematurely. Intra-amniotic injection of T4 appears to be of therapeutic value in enhancing fetal lung maturity.

Amnion↗

Propranolol for the treatment of hypertension in pregnancy.

Twenty-five women were treated with propranolol during 26 pregnancies complicated by hypertension. The fetal wastage, which had been 48 per cent before treatment with propranolol was reduced to 15.4 per cent, with one missed abortion and three stillbirths. Of the 22 liveborn infants 2 were small-for-dates but all 22 had Apgar scores of 9 or 10 at five minutes. There were no congenital anomalies in 25 viable infants and none of the 22 liveborn infants had clinical or laboratory evidence of hypoglycaemia. The blood pressure was controlled in 17 of 19 patients taking propranolol alone (40 to 160 mg/day) and in 6 of 7 taking propranolol with diuretics.

Adult↗

Acquisition of typing serum from post partum blood clots.

The proposed technique provides an inexpensive, totally harmless and rapid procedure for the collection of pregnancy serum having either HLA or anti B-cell cytotoxic activity, Its disadvantages are the necessity for large storage space and the relatively small volume of the obtainable serum.

Blood Coagulation↗