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Biomedical subjects

A Dorfmann

Publications and source records attributed to A Dorfmann.

11 recordsLinked to original sources
PubMed1991

Confirmation of CVS mosaicism in term placentae and high frequency of intrauterine growth retardation association with confined placental mosaicism.

About 2 per cent of specimens from chorionic villus sampling (CVS) analysed either on direct preparation of cytotrophoblast cells or after culture of mesenchymal stroma reveal confined placental mosaicism (CPM), most commonly involving chromosomal trisomy. A significantly higher rate of prenatal loss (22 per cent) as well as the presence of intrauterine growth retardation (IUGR) has been reported among pregnancies with CPM. To evaluate more precisely the effect of these aneuploid cell lines confined to the placenta on intrauterine fetal growth and fetal survival, we have studied 34 term placentae from pregnancies with CPM diagnosed on CVS and confirmed identical mosaicism in 17 of these placentae. There was a direct correlation between a high number of aneuploid cells present at CVS and a high likelihood of their detection in term placenta. Also, the proportion of aneuploid cells in the mosaic term placentae correlated with that observed in CVS specimens. Among 17 gestations with confirmed CPM at delivery, there were six cases of IUGR identified, five in liveborns and one associated with intrauterine death.

Amnion↗
PubMed1990

Small increases in circulating luteinizing hormone (LH) concentrations shortly before human chorionic gonadotropin (hCG) are associated with reduced in vitro fertilization (IVF) pregnancy rate.

The effects of slight elevations in serum LH just before hCG administration on IVF cycle outcome were studied in 219 women undergoing retrieval. One hundred seven patients were stimulated using human menopausal gonadotropin (hMG), and 112 received clomiphene citrate and hMG. Serum LH, estradiol (E2), and progesterone concentrations were measured before and during controlled ovarian stimulation. Retrospectively the women were subdivided into three groups based on serum LH before hCG: Group I, less than 50% LH rise from baseline (BL) value (mean of day 2 and day 7); Group II, LH rise greater than or equal to 50% but less than 2 x BL; and, Group III, LH rise greater than or equal to 2 x BL. The fertilization and cleavage rates were similar in all groups. However, a greater than or equal to 50% rise in serum LH before hCG was associated with a significantly reduced IVF pregnancy rate.

Chorionic Gonadotropin↗
PubMed1988

Chorionic villus sampling: experience with an initial 940 cases.

Of over 1000 patients referred to the Genetics & IVF Institute for chorionic villus sampling, 10% had an abnormal gestational sac at the time of initial presentation. Villus sampling could not be performed in 0.6% of cases, usually because of fibroids. Chorioamnionitis, probably related to the procedure, occurred in two patients (0.2%). The total fetal loss was 2.4%, which is not significantly different from the background fetal loss rate reported in normal pregnancies after eight weeks of gestation. The procedure-related loss was estimated as approximately 0.6%. The cytogenetic analysis routinely used was "direct" trophoblast karyotyping. There were no false-negative diagnoses. Trophoblastic mosaicism was observed in 1.3% of samples. Amniocentesis was performed in 3.5% of cases because of chorionic villus sampling failure, chorionic mosaicism, or elevated maternal serum alpha-fetoprotein (MSAFP) concentrations. Chorionic villus sampling was not associated with falsely elevated MSAFP levels at 15-18 weeks' gestation. Chorionic villus sampling has proved a safe and accurate prenatal diagnostic method associated with relatively low risk when performed by an experienced team, although additional amniocentesis will be necessary in a small percentage of pregnancies.

Adult↗
PubMed1976

[The problem of Caesarean section (author's transl)].

The Caesarean sections at the Universitäts-Frauenklinik Innsbruck from January 1st, 1969 to December 31st, 1974 have been surveyed. Related to the total number of 12 579 deliveries 627 Caesarean sections have been performed. Two 3-year-intervals have been compared: 1969-1971 (group I) without and 1972-1974 (group II) with modern practices of prenatal supervision. There was a high significant increase of the section rate in group II (5,8% versus 4,1% which has been related to the increasing number of mainly fetal indications. The maternal morbidity didn't rise with the increasing section rate. A significant decrease in total infant mortality rate and mortality rate at vaginal deliveries has been found with the increasing incidence of Caesarean sections; whereas the number of depressed infants (Apgar score less than 7) was increased in group II. The reasons therefore have been discussed. The rise of the number of Caesarean sections in group II performed because of breech presentation (14,2% versus 6,2%) was correspondent with a statistically significant decrease in the mortality rate from 11,7 to 4,1%. A Caesarean section rate between 7% and 10% seems to be the limit at least in our hospital--the total infant mortality rate cannot be reduced by further increasing the section frequency: the infant mortality rate possibly could be lowered by a better and more wide spread prenatal care especially by taking more care for prematurity and by intensifying the perinatal period.

Apgar Score↗
PubMed1975

[Significance of various oxytocin challenge tests in monitoring pregnant women at risk (author's transl)].

Three different oxytocin challenge tests were used for the anssessment of placentar function in pregnant women at risk: For the oxytocin test after Ray et al. Oxytocin was given in continuity with rising doses. In the two other tests Oxytocin was given intermittently with identical doses. The test described by Ray et al. Proved useful for predicting respiratory insufficiency of the placenta. The two other intermittent tests are, according to our investigations, less suitable as tests of placentar function because their significance is limited or non-existent. The continuous oxytocin challenge test takes more time (one hour on average). Essential for exact interpretation are a careful technique and surveillance of the patient throughout the test by trained personel. In our opinion the indications for the continous oxytocin challenge test are pregnancies at risk, where antepartum cardniotocography shows suspect or hard-to-interprete results (e.g. non-classifiables decelerations, loss of fluctuation, absence of Braxton-Hicks contractions) or when other monitoring techniques indicate placentar insufficiency (e.g. low oestriol excretion). The test is not suitable in placenta previaprevia, threatened premature birth and premature ruptur of the membranes. In contrast to other authors we cannot decide with certainly whether patients with a positive oxytocin challenge test should in every case be treated with Caesarean section [9]. This decision will depend not only on the result of the test but on the assessment of all parameters, mainly on the clinical picture. In any case delivery of patients with positive oxytocin challenge tests will have to be carried out under strict technical and biochemical supervision.

Cesarean Section↗