PubMed Health⌕ Search

Biomedical subjects

B Arabin

Publications and source records attributed to B Arabin.

64 records · Page 4Linked to original sources
PubMedDate not supplied

Liver rupture postpartum associated with preeclampsia and HELLP syndrome.

Liver rupture is a rare perinatal complication with high maternal mortality. In a multiparous woman with preeclampsia and Hemolysis, Elevated Liver enzymes, and Low Platelet count (HELLP) syndrome, liver rupture was suspected 10 h after a cesarean section. Laparotomy revealed liver rupture which was treated by perihepatic packing. Eventually, the mother was discharged with her baby 88 days after admission. Clinical symptoms, maternal hemodynamics by Swan-Ganz monitoring, and laboratory findings were not predictive until the emergency situation and the consecutive complications required multidisciplinary management.

Adult↗
PubMedDate not supplied

Treatment of twin-twin transfusion syndrome by laser and digoxin. Biophysical and angiographic evaluation.

OBJECTIVES: A combination of surgical and medical approaches may address both the underlying pathophysiological processes and the most threatening symptoms in twin-twin transfusion syndrome (TTTS). CASE: A primigravida with monochorionic twin pregnancy was referred with signs of TTTS at 16 weeks. One twin was severely hydropic with normal amniotic fluid, the co-twin had anhydramnios. Laser treatment was performed. Nevertheless, signs of severe cardiac decompensation in the recipient remained unchanged. After treatment with digoxin restoration of congestive heart failure and a resolution of the hydrops were achieved. Activity and inter-twin contacts increased significantly. At 37 weeks 2 healthy boys were delivered. Postnatal computerangiography of the placenta revealed no arteriovenous anastomoses. CONCLUSIONS: This case suggests that a combined causal and symptomatic therapy in cases with cardiac decompensation of the recipient can be beneficial as demonstrated by echocardiography, venous Doppler and behavioral analysis. Computer angiography of the placenta may demonstrate the effect of laser treatment.

Adult↗
PubMedDate not supplied

Prediction of fetal distress and poor outcome in intrauterine growth retardation--a comparison of fetal heart rate monitoring combined with stress tests and Doppler ultrasound.

One hundred and three intrauterine growth retardation (IUGR) pregnancies were scheduled for pulsed Doppler ultrasound of the common carotid and the umbilical artery, nonstress and contraction stress tests (NST/CST) as well as vibroacoustic stimulation tests (VAST). The last examinations < 3 days before birth were compared by receiver-operator characteristics: Results of the resistance indices of fetal common carotid/umbilical artery and NST were more predictive of later fetal distress during labour, compared to CST and VAST (p < 0.001/< 0.01). Similar results were found for the prediction of low pH and Apgar values, though differences were less pronounced. Our results suggest that stressful examinations should be abolished from mother and fetus in the supervision of IUGR.

Female↗
PubMedDate not supplied

Successful treatment of primary fetal hydrothorax by long-time drainage from week 23. Case report and review of the literature.

We report on a case of unilateral primary fetal hydrothorax leading to nonimmunological fetal hydrops (NIHF). The NIHF was treated successfully by inserting two consecutive intrauterine catheters at 23 weeks gestation. The first catheter was dislocated through the uterine wall to the maternal peritoneal cavity. At 36 weeks gestation, the mother had a spontaneous onset of labor after premature rupture of membranes and a normal vaginal delivery of a healthy infant with good perinatal outcome. Shunting of PFHT has rarely been described up to now. This case report supports observations of previous authors that early shunting of pleural effusions may prevent progression of NIHF as well as postnatal pulmonary hypoplasia. Unexpected perinatal complications of fetus, mother or both should not be neglected.

Adult↗
PubMedDate not supplied

Prediction of fetal distress and poor outcome in prolonged pregnancy using Doppler ultrasound and fetal heart rate monitoring combined with stress tests (II).

Postterm pregnancies of more than 290 completed gestational days (n = 110) were simultaneously supervised after admission by pulsed Doppler ultrasound of the common carotid and the umbilical arteries, nonstress and contraction stress tests (NST/CST) and vibroacoustic stimulation tests (VAST). The results of these tests were blinded for the clinicians. Further decision making was based mainly on fetal heart rate (FHR) monitoring. The prognostic value of tests performed < 3 days before birth predicting fetal distress, low Apgar and pH values in the umbilical artery were compared by receiver operator characteristics. Results of the NSTs and fetal Doppler measurements of the ratio of resistance indices of common carotid/umbilical artery were more predictive of later fetal distress than both, VAST and CST (p < 0.01, p > 0.05, respectively). There were no significant differences in the prediction of low Apgar values. NST was the only significant test for predicting a low pH in the umbilical artery immediately after birth compared to the other examinations (p < 0.05). The results suggest that even in prolonged pregnancies VAST and CST might be released from routine supervision.

Apgar Score↗
PubMedDate not supplied

[Significance of rheobase determination in detection of threatened premature labor].

In a prospective study of 176 pregnant patients it could be proved that the rheobase measurement during the whole course of pregnancy plays a significant role in recognizing the danger of premature labour. Taking a pathological limit from a number of rheobase determinations at a level of 3,4 mA, we had a sensitivity of 81% and a specificity of 50% in forecasting a premature delivery. The rheobase levels did not correlate significantly with the pelvic score (Bishop) and no correlation was found with the number of contractions measured tocometrically, nevertheless there was a correlation with the number of painful contractions between the 26th and 32nd week of gestation. Furthermore, we were able to certify the influence of psychic factors on the rheobase levels. As a result of our tests we consider the rheobase determination as being an independent, valid method for indicating premature labour. For this reason we included this procedure in our screening programme for recognition of threatened prematurity (Kubli u. Arabin, 1984).

Arousal↗
PubMedDate not supplied

[Significance of Doppler blood flow studies in twin pregnancies].

Twin pregnancies are characterized by similar uteroplacental but different fetoplacental haemodynamics at the same gestational age. The aim of this study was to investigate the correlation between Doppler blood flow measurements of fetal vessels and the morphological findings of the placenta, fetal growth and signs of fetal hypoxia. The study group consists of 18 twin pregnancies with operative delivery. In all cases the placenta was examined morphologically. We found similar discordancies in the pulsatility index (PI) or the mean blood flow velocity (Vmean) of the fetal aorta (measurements less than 7 days before delivery) and the birth-weight. In twin pregnancies with operative delivery due to fetal indication in 11 out of 12 cases the twin with suspected hypoxia had a relatively lower Vmean and a higher PI value. The association of pathological blood flow velocity waveforms of the umbilical artery, the fetal aorta and the fetal common carotid artery and histomorphological findings of the placenta could be demonstrated.

Aorta↗
PubMedDate not supplied

[Economy circuit of fetal circulation illustrated on the basis of personal quantitative Doppler blood flow parameters].

Percentile curves of the mean blood flow velocity and the mean blood flow volume of the fetal aorta were calculated from a normal study group comprised of 290 pregnant women. Additionally ratios of the mean blood flow velocity or blood flow volume of the fetal common carotid artery and the fetal aorta were established. In a high risk group with a loss of end-diastolic blood flow velocities in the umbilical artery and/or fetal aorta and subsequent primary caesarean section due to fetal distress (pathological CTG) we investigated the course of the above mentioned parameters. The ratio of the mean velocity or the mean blood flow volumes showed and increased in all 10 cases of the high risk group from the first to the last measurement. In all cases the final level before the delivery was far above the 95th centile. The underlying pathophysiological occurrence of the conserving adaptation of the fetal circulation is expressed by the ratios. This is why we consider these parameters to be of great importance in the supervision of high risk pregnancies in the future.

Aorta, Thoracic↗
PubMedDate not supplied

[Actocardiograph--an instrument for the diagnosis of fetal behavioral stages?].

The investigation of fetal behaviour are an important clinical tool for assessing fetal well-being. However, they are time-consuming and at least 2 real-time scanners must be employed. The aim of this study was to find out if fetal behavioural states can be diagnosed by using only the "actocardiograph". Thus we compared tracings of the actocardiograph with simultaneously registered tracings from "polygraphic monitorings" including real-time observations of fetal eye, breathing and body movements. We could demonstrate that state 1F and 4F can be recognised in 93% resp. 82%. Periods without a definite state cannot be diagnosed from actocardiographic tracings. This suggested that the combined recording of fetal movements and fetal heart rate with the actocardiograph might be useful for the registration of fetal movements and for the overall diagnosis of fetal behavioural states. However polygraphic monitorings including real-time observations give the only precise picture of neuromotoric coordination.

Embryonic and Fetal Development↗