[Vacuum or forceps?].
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Extraction, Obstetrical↗
Biomedical subjects
A Samueloff
Publications and source records attributed to A Samueloff.
Fryns syndrome: a predictable, lethal pattern of multiple congenital anomalies.
Fryns syndrome is a unique pattern of lethal multiple congenital malformations with variable expression. A family in which all four sibs conformed to Fryns syndrome is detailed and substantiates the criteria for definition of the syndrome; perinatal mortality, hypoplastic lungs, and facial deformities should be highly suggestive of the syndrome. The addition of a strong family history, diaphragmatic hernias, distal limb deformities, and early onset of polyhydramnios with subsequent premature delivery should definitely confirm the diagnosis.
Abnormalities, Multiple↗
Incidence of spontaneous and evoked fetal movements.
Fetal activity is composed of fetal movements (FM), which are either nonreflexive, originating in the fetus itself, or evoked reflexive FM which are stimulated by the fetal environment. The relative ratio of the spontaneous to evoked FM has not yet been documented. Since it is impossible to differentiate in a singleton pregnancy between these two types of FM on the basis of maternal perception alone, the natural model of twin pregnancy was used. It has previously been shown that the number of FM in a singleton pregnancy is similar to that of each individual fetus in a twin pregnancy of the same gestational age. It was assumed that the factors which cause spontaneous and evoked FM are similar in singleton and twin pregnancies. The fetal activity in 44 twin and 76 singleton pregnancies between 28 and 39 weeks of gestation was assessed during 20 min of nonstress test recording. The means of FM in twins were significantly higher than those in singleton pregnancies. The rate of the spontaneous FM was calculated to be 50-59% of all FM in singleton pregnancies and that of the evoked FM 41-50%.
Female↗
Fetal heart rate accelerations and fetal movements in twin pregnancies.
The rate of fetal heart rate accelerations associated with fetal movements to total fetal movements of twin pregnancies was found to be significantly lower than that of pregnancies with singleton infants. The number of fetal heart rate accelerations was similar. As fetal heart rate accelerations are reflective of fetal movements, the results indicate increased fetal activity in twins that is related to an additive effect of two normally active fetuses.
Female↗
Pulmonary complications following endotracheal intubation for anesthesia in breech extraction.
A 28-year-old, healthy pregnant patient developed bilateral pneumothorax, subcutaneous emphysema, pneumomediastinum, pneumoretroperitoneum and pneumoperitoneum following endotracheal intubation and manual ventilation during general anesthesia for breech extraction. It is likely that positive-pressure ventilation was the cause for this very rare combination of complications. Early recognition and treatment may prevent such a catastrophe.
Adult↗
Congenital afibrinogenemia and recurrent early abortion: a case report.
The role of the fibrinogen molecule in the maintenance of normal pregnancy is not yet well understood; however, several cases have been previously reported in which failure to complete normal pregnancy was associated with either hypofibrinogenemia, dysfibrinogenemia, or deficiency in factor XIII (fibrin-stabilizing factor) which is important for the crosslinking of the fibrin. A case of congenital afibrinogenemia is described. The patient, a 22-yr-old woman, who suffered from a moderate hemorrhagic tendency associated with very low (less than 10 mg/dl) plasma fibrinogen levels, had three consecutive spontaneous abortions. In view of the previous cases reported, the question is raised whether patients with low or abnormal fibrinogen should be treated with plasma transfusions in order to maintain a normal pregnancy.
Abortion, Habitual↗
Nonimmunologic hydrops fetalis: a review of 11 cases.
Eleven cases of nonimmunologic hydrops fetalis occurring during a six year period were reviewed. The etiology of hydrops fetalis was established only in four cases. It included one case of endocardial fibrosis, two cases of non-immunologic hemolysis and one case of tachycardia. The pregnancies were complicated by polyhydramnios in 9 cases, preterm delivery in 10 cases, twins in 3 cases and pre-eclampsia in one case. Four of 11 fetuses died in utero, on one of them, intrauterine blood transfusion and administration of digoxin and furosemide was carried out. Five fetuses died neonatally and two survived. In one of the later cases, intravenous administration of digoxin with quinidine to the mother was without effect, nor did such treatment cause any effect on the neonate after delivery. Electric cardioversion supplemented with digoxin slowed the neonatal cardiac rhythm to normal range with later successful outcome. Earlier diagnosis by ultrasonography especially in cases of hydramnios and appropriate treatment are likely to improve this outcome.
Adult↗
Fetal movements in isoxsuprine-treated patients.
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Female↗
The effect of phenoxybenzamine on postoperative urinary complications during extradural morphine analgesia.
One hundred and fifty patients, post-Caesarean section, were investigated to evaluate the effect of epidural morphine analgesia and that of phenoxybenzamine on the frequency and extent of urinary complications. Forty patients (group A) underwent Caesarian section under general anaesthesia, while 110 patients received epidural anaesthesia. Of the latter patients, 40 received postoperative mild analgesics (group B) whilst in another 40, postoperative continuous epidural morphine was administered (group C). Thirty patients who received postoperative epidural morphine, also received oral phenoxybenzamine 10 mg, 24 and 1 hr prior to, and 8 and 16 hr following surgery (group D). The volume of urine of the first two postoperative voidings, the time delay to first micturition, difficulty in micturition and urinary retention necessitating bladder catheterization were studied. The mean volumes of the first two postoperative voidings were markedly reduced in group C (219 and 218 ml, respectively) as compared with group A (383 and 453 ml) and with group B (319 and 414 ml, respectively). In group D, these mean volumes were significantly larger at 478 ml (p less than 0.01) and 417 ml (p less than 0.01) as compared with those of group C. The mean time to the first postoperative voiding was 582 min in group C, which was significantly longer than that in group A (339 min) or in group B (448 min). In the patients treated with phenoxybenzamine, the time to the first postoperative voiding was significantly less at 322 min (p less than 0.01). The need for bladder catheterization was also increased in group B compared with group A, while in group C this increase was marked compared with both groups A and B. It was significantly less frequent in those receiving phenoxybenzamine. Phenoxybenzamine is recommended in the prevention of postoperative urinary complications associated with epidural anaesthesia and epidural morphine analgesia.
Adult↗
[Pulmonary edema occurring after isoxsuprine treatment for preterm labor].
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Female↗
Fetal movements in multiple pregnancy.
Fetal activity in multiple pregnancies, as expressed by maternal daily fetal movement recordings, was compared with that in singleton pregnancies. It was found that the mean fetal activity in 33 cases of twins, six cases of triplets, one case of quadruplets, and one case of quintuplets was generally higher than that obtained during singleton pregnancies. In most cases, fetal movements of triplets, quadruplets, and quintuplets were even higher than the movement of twins.
Female↗
Pulmonary edema occurring after isoxsuprine and dexamethasone treatment for preterm labor: Case report.
A case of maternal pulmonary edema occurring in a patient in the 32nd week of gestation is presented. This was our first case of pulmonary edema seen during a period of five years' usage of isoxsuprine in the treatment of premature labor. The patient presented was 28 years old, gravida 2, para 1, admitted to the maternity ward with premature uterine contractions. Her past history eliminate cardiac or pulmonary disease. Isoxsuprine therapy was begun with initial dose of 0.04 mg/min. and increased to 0.32 mg/min., the total dose administered was 560 mg during 48 hours. During this period she was given in dexamethasone 24 mg. Fluid balance on the first day of the treatment was +1.7 liters and on the second day +5.2 liters. Forty-eight hours from the commencement of the treatment, the patient experienced shortness of breath and chest pain. Physical examination disclosed wet rales over both lungs, sinus tachycardia and tachypnea. Laboratory examination disclosed hypopotassemia of 3 mEq/liter, hypoxemia (PO2 of 80 torr on 0.5 FiO2 face mask) with mild hyperventilation 28 torr PCO2 with normal ph 7.43. Recognition of the early signs of pulmonary edema enable swift clinical diagnosis and steps to be taken to prevent disasterous condition due to progressive hypoxemia. The prompt treatment in this complication includes discontinuation of isoxsuprine and fluid administration, placement of the patient in an erect position, intravenous furosemid 40 mg, oxygen supplement by face mask and 25 mg of meperidine. The patient's condition dramatically improved though the lung fields became completely clear from wet rales only eight hours from the start of dyspneic attack.(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗
The effects of the socioeconomic status on the perinatal outcome of grand multipara.
Grandmultiparity has been considered as an obstetric hazard both to the mother and the fetus. Since high paritius tend to be more common in the lower socioeconomic groups, the effect of the socioeconomic status on perinatal outcome was evaluated in this study. This survey covers all the deliveries in Israel (22,815) in a 3 month period. The 1542 grand-multiparous women were divided into two groups: low socioeconomic group (947) and high socioeconomic group (595). Perinatal mortality and low birth weight were found to be in correlation with low socioeconomic status but not with grand multiparity. Maternal diseases complicating pregnancy were found to be significantly more common for grand multipara for both socioeconomic groups. This study shows that the grave association of parity and mortality found for the total population was due to the predominance of parturients of low socioeconomic class in the high birth order group.
Adult↗
The human sperm hypoosmotic swelling test: its practical application and suggestions for improvement.
Semen samples of 209 males of infertile couples were evaluated by the sperm hypoosmotic swelling (HS) test, the in vitro human sperm zona-free hamster ovum penetration assay (SPA), and by the three main parameters of the spermatogram (concentration, motility, and morphology). Whereas the HS test and SPA were poorly correlated with one another, the former showed a correlation with motility, particularly in oligo-, astheno-, and teratospermic semen samples. The simple and inexpensive HS test may prove a worthwhile tool in the diagnosis of male infertility.
Humans↗