Real-time ultrasound B-scan as an aid to antepartum fetal heart rate monitoring in multiple pregnancy. Case report.
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Female↗
Biomedical subjects
B K Wittmann
Publications and source records attributed to B K Wittmann.
Electronic area and perimeter measurement of ultrasonic images.
An electronic system for measuring area and perimeter directly on cross-sectional ultrasonic images is described. The resulting values are unaffected by the distortions common to display monitors or errors in the display scale factor. The results of accuracy tests are given, including a comparison with measurements by planimeter and map-measurer.
Ultrasonics↗
Cyclic 3',5' -adenosine monophosphate in umbilical cord and maternal plasma before and after the onset of parturition.
Significant arteriovenous differences in cord cyclic 3',5'-adenosine monophosphate (cAMP) levels and between the maternal plasma (MP) and each cord vessel (mean umbilical artery [UA] greater than umbilical vein [UV] greater than MP) was observed. cAMP levels were significantly higher in the umbilical cord vessels and maternal plasma after vaginal delivery than they were following delivery by elective cesarean section before the onset of labor. The higher mean cAMP levels observed after parturition appeared to be more pronounced in the fetoplacental unit than in the maternal compartment. A significant positive correlation in cAMP levels between the UA and UV was also observed.
Cesarean Section↗
Diagnostic ultrasound in the management of patients using intrauterine contraceptive devices.
A group of 80 patients was scanned by ultrasound within 24 hours of insertion of an intrauterine contraceptive device (IUCD) and re-examined clinically and/or by ultrasound after the next menstrual period. An attempt was made to identify factors such as uterine size, uterine flexion and the position of the IUCD which might be related to its expulsion or removal when, on initial scanning, the device was not located in the fundal area; removal was necessary in 5 out of 6 patients. In patients with an endometrial cavity of less than 40 mm length and/or acute uterine flexion, the overall figure for expulsion and removal was 54 per cent (13 out of 24). It is hoped that a consideration of these factors will lead to a reduction of the failure rate of the IUCD.
Cervix Uteri↗
Ultrasound fetal biometry charts for a North American Caucasian population.
PURPOSE: This study was done to produce enhanced fetal biometry charts and graphs presenting percentile values as a function of fetal age. METHODS: The relationships between the ultrasound measurements of 10 fetal parameters and menstrual age were determined by a cross-sectional study. Data were obtained from 508 to 790 fetuses. Anatomic structures were scanned and measured 3 times during 1 routine sonographic examination. The study group consisted of 1,396 Caucasian women who had normal singleton fetuses with confirmation of menstrual dates by sonography before 14 weeks and for whom complete pregnancy outcome information was available. For each of the 10 parameters, percentile curves were derived for the 5th, 10th, 25th, 50th, 75th, 90th, and 95th percentiles. RESULTS: Ready-to-use fetal measurement charts and graphs are presented in a format giving the percentile values as a function of fetal age. There were no significant differences between male and female fetuses. CONCLUSIONS: These fetal biometry charts and graphs, obtained from a North American Caucasian population, enhance previously published data.
Abdomen↗
Sonographic measurement of the fetal femur: factors affecting accuracy.
Variations have been observed in the measurement of fetal femoral diaphysis length by ultrasound. This in vitro study examines the effect of depth, the angle of the bone relative to the axis of the sound beam, the machine, and the observer on the precision of measurement. Using analysis of variance techniques, it demonstrates that three of these factors (depth, angle, and machine) have significant effects. Depth-associated variations were less than one millimeter and are probably not of clinical importance. However, the variations due to changes in angle are highly significant (P = less than 0.001) and may be controlled by obtaining the measurement with the femur perpendicular to the sound beam. Errors due to variation between machines were also highly significant (P = less than 0.001). When determining serial growth patterns, the errors due to variations between machines can be controlled by using the same machine for each examination. The variation between machines is also an important factor to consider when choosing a curve for reference purposes.
Embryonic and Fetal Development↗
Cordocentesis: overall pregnancy loss rate as important as procedure loss rate.
A 4-year retrospective review of cordocentesis at a single center with four operators identified 182 patients undergoing 214 cordocenteses. The major indications were chromosomal, fetal platelet and rhesus evaluation. The procedure was successful in 95%. A positive genetic diagnosis was present in 18% with 64% having trisomy 18, 21 or 13. The procedural pregnancy loss rate was 3.25, 1.25 and 2.75% for chromosomal and nonchromosomal indications and total population, respectively. The overall fetal loss rate (procedural, nonprocedural) in chromosomal risk population was 47%. This overall pregnancy loss risk should be included in patient counselling.
Chromosome Aberrations↗
Selective feticide in twin transfusion syndrome using ultrasound-guided insertion of thrombogenic coils.
Twin transfusion syndrome is a common complication of monozygotic twin pregnancies. Selective feticide is one of the many different aggressive and invasive therapies that has been suggested to improve an otherwise dismal perinatal outcome. The ideal method of selective feticide remains to be delineated for cases of twin transfusion syndrome that occur remote from term. We describe a case involving the use of intracardiac placement of thrombogenic coils to attempt selective termination.
Adult↗
Antenatal invasive and noninvasive management of alloimmune thrombocytopenia.
The outcome analysis of 10 pregnancies at risk for neonatal alloimmune thrombocytopenia (NAIT) is presented. An experimental protocol of cordocentesis and maternal administration of intravenous immunoglobulin (IVIG) is compared to a control group of older untreated affected siblings. The outcome in pregnancies treated with IVIG shows improved fetal platelet count in 70% and no intraventricular hemorrhage. We conclude that maternal administration of IVIG appears to improve clinical outcome in fetuses at risk for NAIT.
Cerebral Hemorrhage↗