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Biomedical subjects

V R Klein

Publications and source records attributed to V R Klein.

27 records · Page 2Linked to original sources
PubMed1985

Cost-effective criteria for glucose screening.

To study cost-effective screening criteria for gestational diabetes, a prospective study of 1012 patients was completed. All patients underwent a glucose screen between 26 and 30 weeks of gestation, consisting of a 50-g oral glucose load followed by a one-hour plasma glucose determination. Patients with a glucose screen greater than or equal to 130 mg/dL were studied with a standard three-hour oral glucose tolerance test. The incidence of gestational diabetes was 2.4% (24 of 1012). Only one gestational diabetic was identified with a glucose screen below 150 mg/dL. Twenty-two of the 24 cases were at least 24 years old. Twenty-one of the 24 (88%) gestational diabetes had a glucose screen greater than or equal to 150 mg/dL and were 24 years old or greater. The cost of the diagnosis in these latter patients was 40% of the cost of diagnosis of universal screening with a threshold of 130 mg/dL. It is concluded that screening with a threshold of 150 mg/dL only patients who are at least 24 years old should be considered an alternative to universal screening.

Adult↗
PubMed1985

Choriocarcinoma of the ovary.

Six cases of primary ovarian choriocarcinoma were reviewed. Five-year follow-up was available for all patients except the most recently diagnosed case. Overall survival was 80%. The problems of distinguishing between gestational and nongestational neoplasia and differentiating primary from metastatic disease are discussed. Surgical staging of disease may be more informative in initiating aggressive chemotherapy than in determining the gestational or nongestational origin of the tumor.

Adult↗
PubMed1984

Fetal distress during a maternal systemic allergic reaction.

Systemic allergic reactions to food ingestion rarely result in life-threatening situations. When these reactions occur during pregnancy, however, the accompanying physiologic changes may result in fetal distress. A case of repetitive late decelerations in the fetal heart rate during a maternal allergic reaction is presented. Prompt and aggressive medical management brought about total resolution of maternal and fetal compromise.

Adult↗
PubMedDate not supplied

Fetal breasts in normal and Down syndrome fetuses.

UNLABELLED: To assess the validity of fetal breast size measurement as a sonographic marker in fetuses with Down syndrome. METHODS: Fetal breasts were studied in 26 fetuses with trisomy 21 and 78 fetuses with normal chromosomes. Breasts were identified and measured in a cross-sectional plane of the fetal chest at the level of the four-chamber view of the heart. Normal fetuses had a mean breast size of 3.8 mm +/- 1.1 mm. Fetuses with Down syndrome had a mean breast size of 1.9 mm +/- 0.7 mm (p < or = 0.0001). Diminished breast size measured by ultrasound in the second trimester may be helpful in identifying fetuses with Down syndrome.

Breast↗
PubMedDate not supplied

Clinical significance of echogenic foci in fetal lungs.

PURPOSE: We reviewed our experience with echogenic foci in fetal lungs. METHODS: During the period January 1991 through December 1995, 16,292 patients underwent comprehensive ultrasound examinations between 16 and 42 weeks of pregnancy. Echogenic foci in the lungs were identified in 8 fetuses. All 8 underwent karyotyping, fetal echocardiography, screening for infectious agents, and follow-up sonography. The neonatal outcome was obtained in each case. RESULTS: The 5 fetuses in whom echogenic foci in the lungs were the only abnormal finding all had normal outcomes. One fetus had echogenic foci identified in 1 lung and the abdomen. This fetus tested positive for cytomegalovirus, and the pregnancy was terminated. Two fetuses with echogenic foci in the lungs had associated anomalies: 1 had an omphalocele, and the other had cerebral ventriculomegaly. Both of these pregnancies were terminated. CONCLUSIONS: In our series, isolated echogenic pulmonary foci were rare findings that carried a good prognosis. When echogenic foci in the lungs are identified, careful evaluation for associated abnormalities is warranted.

Female↗
PubMedDate not supplied

Cordocentesis using the combined technique; needle guide-assisted and free-hand.

Two hundred and sixteen diagnostic cordocenteses were performed using the following technique: A guide was used to deliver the distal end of the needle to the immediate vicinity of the umbilical cord, after which the needle was released from the guide and a free-hand technique was used to enter the umbilical cord. The vessel punctured was identified by its sonographic appearance and flow direction using color Doppler technology. All procedure-related losses which occurred within 2 weeks were analyzed. The gestational age at the time of cordocentesis ranged from 18 to 42 weeks. Most punctures (62%) were performed at the placental insertion of the umbilical cord. In 32% of fetuses the free-floating loop was sampled and in 6% the puncture was performed at the site of cord entry into the fetus. Two fetuses died shortly after cordocentesis. One death occurred at 28 weeks in a fetus with severe cytomegalovirus infection. The other death was due to premature rupture of the membranes after the procedure in a very premature fetus. The overall fetal loss rate was 0.93%. In conclusion, the combination of the two cordocentesis techniques appears safe and highly successful in obtaining fetal blood samples.

Cordocentesis↗
PubMedDate not supplied

Partial molar pregnancy associated with severe pregnancy-induced hypertension.

Although the natural history of pregnancies associated with complete hydatidiform mole has been well described, the clinical features of partial mole are less consistent. We managed five partial molar pregnancies complicated by severe pregnancy-induced hypertension in the second trimester. We describe the differentiation between complete and partial mole, and the unusual clinical presentation in our patients.

Abortion, Therapeutic↗