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Biomedical subjects

S Mor-Yosef

Publications and source records attributed to S Mor-Yosef.

At least 19 recordsLinked to original sources
PubMed1992

The Israel perinatal census.

A nation-wide perinatal census which included 22,815 deliveries was carried out. The cesarean section rate was 9.6% and the perinatal mortality rate was 13.5/1000. Using a logistic regression analysis the risk factors for cesarean section and for perinatal mortality were ranked. Breech presentation and one uterine scar were found to be the most important risk factors for cesarean section and breech presentation, maternal disease and multiple pregnancy for perinatal mortality. Low birth weight rate was 6.9% with nonsignificant differences between the various ethnic groups. The national cesarean section rate in breech presentation was 57.8%. It was performed mainly at the extremes of birth weight. From those with one previous cesarean section 55.1% delivered vaginally and 44.9% abdominally. The chance for vaginal delivery is higher (67.2%) providing the woman had delivered vaginally in the past. Comparison between primiparae and multiparae showed that preeclampsia, hypertension and diabetes mellitus were all significantly more frequent among older parturients and among primiparae.

Adolescent↗
PubMed1990

The effect of maternal age and socioeconomical background on neonatal outcome.

This population-based study examined whether the neonatal outcome of primiparae is determined by maternal age or by her socioeconomic background. Data on all births in Israel during a three-month period was made available from a nation-wide census. Primiparae 30 years of age or older had a significantly (P less than 0.001) higher risk of low birthweight and prematurity. Perinatal mortality rates and low 5-min Apgar scores were not associated with maternal age, but were significantly (P less than 0.001) increased for the socioeconomically disadvantaged parturients. Our results suggest the growth retardation and short gestation among older primiparae may reflect biological aging of maternal tissues and the effect of diseases of pregnancy such as hypertension and preeclampsia, found significantly (P less than 0.001) more common for these mothers. Excessive perinatal mortality, on the other hand, may be attributable to environmental disadvantage of socioeconomically deprived populations.

Adult↗
PubMed1990

Role of centralization of surgery in Stage IB carcinoma of the cervix: a review of 498 cases.

A review was undertaken of 498 patients with stage IB carcinoma of the cervix managed over a 15-year period in the Regional Gynaecological Oncology Centre, Gateshead. All but 4 were treated by radical hysterectomy, with adjuvant radiotherapy and/or chemotherapy for those with involved pelvic nodes. The overall 5-year survival in those with negative nodes was 91.4% compared with 50.5% in those with positive nodes (P less than 0.05). Of those dying from the disease, 7 patients only (1.4%) developed central recurrence, the remainder experiencing pelvic side-wall or distant recurrence. There was no difference in survival related to patient age. There were three deaths related to surgery and a fistula rate of only 1.2%. Bladder hypotonia and lymphocyst affected a minority of patients in the long term. The data support the case for radical surgery in stage IB carcinoma of the cervix, managed on a centralized referral basis.

Adult↗
PubMed1990

Vaginal delivery following one previous cesarean birth: nation wide survey.

The present state of vaginal delivery following a previous cesarean section (CS) was evaluated through a nation wide survey, including 22,815 deliveries. The overall cesarean rate was 9.6%. Of all the parturients with one previous cesarean section 55.1% delivered vaginally. A previous CS and labor arrest were the major indications for a repeated CS in 28.7% and 26.4%, respectively. Rupture of the uterus following vaginal delivery was found more often in the group with a previous CS than in those with no uterine scar (1.2% and 0.03%, respectively), (P less than 0.0001). None of the uterine ruptures was fatal neither to the mother nor to the fetus. Post partum fever appeared more often among vaginal deliveries following a CS than among those with no uterine scar. However, CS is followed by fever 10.8 times more than vaginal delivery. Intrapartum and neonatal death rates following vaginal delivery were similar for those with or without a previous CS (3.42% and 3.38%, respectively). An average of 3 hospitalization days were saved for each vaginal birth replacing a repeated CS. It is concluded that vaginal delivery, following CS, does not cause substantial morbidity, nor mortality either to the mother or the neonate, and may be practiced with a reasonable margin of safety in well selected cases.

Adolescent↗
PubMed1990

Is routine colposcopic assessment necessary following laser ablation of cervical intraepithelial neoplasia?

The colposcopic and cytological findings at follow-up of 1000 women treated by laser ablation for cervical intraepithelial neoplasia or human papillomavirus infection at the Regional Department of Gynaecological Oncology, Gateshead, were reviewed. Colposcopy detected six of 27 patients with residual disease compared with cytology which was abnormal in 26 of the 27 and detected 21 as abnormal on the first visit after laser treatment. In our unit invasive disease after laser treatment was never detected solely on initial colposcopic review.

Adolescent↗
PubMed1990

Loop diathermy cone biopsy.

A technique for cone biopsy using loop diathermy is presented. The diathermy loop consists of an insulated shaft attached to an insulated transverse or U-shaped arm, to which the loop wire is attached. The diathermy power is supplied by an electrosurgical unit. Among the first 50 cases, the mean age was 41.6 years; 72% of the cases were reported as cervical intraepithelial neoplasia III and 6% as microinvasive carcinoma. The mean length of the cone was 20.2 mm and the mean weight 3.9 g. Only 10% of the cones were reported as incompletely excised. No major complications were observed, and minor complications were reported in four patients (8%). We found this technique to be quick, simple, and economical. It provides a good histologic specimen with a low incidence of short-term morbidity.

Adult↗
PubMed1990

Ranking the risk factors for cesarean: logistic regression analysis of a nationwide study.

The risk factors that influenced the decision to perform cesarean were ranked in a nationwide census of deliveries conducted in Israel. The study encompassed 22,815 women who gave birth between November 1, 1983 and January 31, 1984 in the 30 maternity departments in the country; 2179 deliveries were by emergency cesarean. Multivariate stepwise logistic regression technique indicated that the most important risk factors affecting the decision were the presentation of the fetus and the presence of a uterine scar, followed in descending order by placenta previa or abruptio placentae, maternal disease, primiparity, low birth weight, twins, and advanced maternal age. The mother's ethnic background and type of hospital played an insignificant role in the decision-making process. The specific statistical method applied in this work permits listing the indicators that constitute risk factors for cesarean and provides the net effect of each factor on the decision-making process.

Cesarean Section↗
PubMed1989

Gastrin-producing ovarian cystadenocarcinoma: sensitivity to secretin and SMS 201-995.

We report a patient with severe peptic ulcer disease and a right ovarian mass that was found to be a gastrin-producing cystadenocarcinoma. Gastrin production by the tumor was stimulated by secretin and inhibited by the long-acting somatostatin analogue SMS 201-995. Following resection of the tumor, serum gastrin levels and the gastrin response to secretin returned to normal. Histologic examination, including Alcian blue staining for mucin and immunoperoxidase staining for gastrin, revealed gastrin at the base and mucin at the apex of the tumor cells. This report demonstrates secretin stimulation and somatostatin inhibition of gastrin secretion from a cell that is apparently not of endocrine origin.

Cystadenocarcinoma↗
PubMed1989

Malignant melanoma of the uterine cervix: case report and review of the literature.

Malignant melanoma of the uterine cervix is an extremely rare manifestation, and neither retrospective nor prospective studies on this disease entity have been published. A patient with this disease entity is described. In addition, the data contained in 25 published case reports were collated in an attempt to clarify the origin, presenting symptoms, macroscopic appearance, and staging of the tumor. Although there is no consensus as to comprehensive treatment, radical hysterectomy is generally advocated. The prognosis in these patients is poor.

Adult↗
PubMed1989

Is it time for a reconsideration of the criteria for cone biopsy?

Between August 1985 and November 1988, 475 laser cone biopsies were performed at the Regional Gynaecological Oncology Unit in Gateshead. Of these, 332 were performed for abnormal cervical cytology and unsatisfactory colposcopy. The negative cone rate in this group was 34%. In those with cytological abnormalities up to and including mild dyskaryosis the figure was 64% and there were no cases of invasive disease. In this group the authors have reconsidered the criteria for cone biopsy and suggested biopsy of the visible ectocervical lesion combined with endocervical curettage or brushing. Those with negative histology or cytological abnormalities less than moderate dyskaryosis should be managed conservatively.

Adult↗
PubMed1989

Low birth weight in a heterogenic population.

In order to elucidate some of the factors which influence the low birth weight rate, 22,815 deliveries were studied. It is already known that low birth weight (LBW) underlies the majority of infant deaths. It is also associated with an increased risk of permanent disability such as cerebral palsy, learning difficulties, and mental retardation of various degrees in survivors. In modern society these problems require major resources from the health budget. The Israeli population is composed of Jews and non-Jews, who differ not only in their religion but also in their customs. Most of the Jews are immigrants from many parts of the world who still retain many of the habits, customs and lifestyles of the societies they had lived in for many generations. We evaluated the LBW rate in these different groups. Jews and non-Jews have similar rates of LBW and similar mean birth weights. Other factors such as maternal age, parity, and hypertensive disorders of pregnancy showed some statistically significant differences. LBW rates increase from 6.9% in the babies of women aged 24-40 years to 8.5% in those less than 24 years, and 9.5% in those over 40. The risk of LBW was increased in primiparae to 10%. The highest rates were found in babies of mothers with hypertension. Pregnancy induced hypertension is associated with a LBW rate of 15.6% and chronic hypertension with a rate of 23%. Moderate and severe preeclampsia are important risk factors since they increase the rate to 15% and 47.1%, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1989

Ranking risk factors for perinatal mortality. Analysis of a nation-wide study.

This paper analyses data from the Israeli nationwide perinatal census, with the aim of revealing the possible causes of perinatal death, and to assess the effects of risk factors, using a logistic regression analysis. The analysis provided an estimate of the net effect of each characteristic independently, thus identifying high-risk pregnancies that should be monitored with greater intensity. Five variables were found to have a significant effect on perinatal death. Among these, in order of decreasing risk: fetal presentation, maternal diseases complicating pregnancy, number of fetuses, ethnic origin, and maternal age. Other variables such as parity, standard of hospital, the mother's country of birth and domiciliary circumstances, did not significantly affect perinatal mortality.

Adult↗
PubMed1989

The 1984 national perinatal census: design, organization and uses for assessing obstetric services in Israel.

A nationwide perinatal census was conducted in Israel, in which medical, social, ethnic and demographic information on all births that took place in Israel within a predefined 3-month period was collected. The present study is the first to include 22,814 births that took place in all the obstetric units in Israel. The perinatal mortality rate decreased from 23.7 in 1964-68 to 13 in 1983-84. The frequency of cesarean section deliveries almost doubled over the last decade, while the use of forceps decreased significantly and the use of vacuum extraction did not change. The rate of low birthweight, however, remained constant over the last two decades. The level of hospital care has been shown to be significantly associated with perinatal mortality. The Israeli Perinatal Census may be used to provide information needed for promoting priority objectives for pregnancy and infant health, such as improving health status, identifying risk factors, increasing public and professional awareness, and improvement in services by protecting mother and fetus.

Adult↗
PubMed1989

Grand multiparity--a nationwide survey.

Grand multiparity has been considered to be an obstetric hazard to both the mother and the fetus. In order to evaluate this statement we analyzed the information of a nationwide survey. The delivery records of all women (22,814) attending 30 obstetric wards in Israel between November 1983 and January 1984 were analyzed and the medical and obstetric complications associated with grand multiparity were investigated. Diabetes, hypertension, malpresentations, multiple births, large-for-gestational-age deliveries and perinatal deaths were found to be significantly more common in 1,542 multiparae who had seven or more deliveries. The association between parity and age partially accounted for this observation.

Adolescent↗