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Biomedical subjects

B M Petrikovsky

Publications and source records attributed to B M Petrikovsky.

At least 19 recordsLinked to original sources
PubMed2000

Effect of antenatal steroid administration on the fetal biophysical profile.

PURPOSE: Our objective was to determine whether antenatal steroid administration affects the biophysical profile score in fetuses. METHODS: A prospective study was conducted in 84 fetuses between 28 and 34 weeks' menstrual age at risk of preterm delivery. Two intramuscular injections of 12 mg of betamethasone were given to the mother 24 hours apart. All fetuses underwent biophysical profile testing prior to and between 24 and 48 hours after steroid administration. Biophysical profiles (including nonstress tests) were evaluated by two maternal-fetal medicine specialists blinded to the timing of steroid administration. Neonatal outcome, including Apgar score, menstrual age at delivery, admission to and length of stay in the neonatal intensive care unit, and mortality, was analyzed in all subjects. RESULTS: In 31 (37%; 95 confidence interval, 26.6-47.2%) of 84 cases, the biophysical profile score decreased at least 2 points after steroid administration. The most commonly affected variables were fetal breathing and the nonstress test. There was no significant difference in the neonatal outcome between the fetuses whose biophysical profile decreased and those whose did not. CONCLUSIONS: Biophysical profile scores were decreased in more than one third of fetuses within 48 hours of antenatal steroid administration, but neonatal outcome was not affected. Knowledge of this occurrence could avoid incorrect decision making regarding fetal well-being.

Adult↗
PubMed1998

Cephalhematoma and caput succedaneum: do they always occur in labor?

OBJECTIVE: Our purpose was to analyze our experience with cephalhematomas detected prenatally by ultrasonography. STUDY DESIGN: Seven cases of cephalhematomas were identified prenatally among 16,292 fetuses having comprehensive ultrasonographic examinations between 1993 and 1996. The course of pregnancy and the neonatal outcome were reviewed in each case. RESULTS: Cephalhematomas appeared as an echogenic bulge posterior to the occipital region (5 cases) or at the temporal region of the fetal head (2 cases). CONCLUSION: Cephalhematomas, which are believed to be a result of operative delivery, can also originate, in utero, antepartum. Premature rupture of membranes appears to be an associated factor.

Birth Injuries↗
PubMed1997

Prediction of fetal macrosomia using sonographically measured abdominal subcutaneous tissue thickness.

PURPOSE: We assessed the usefulness of sonographic measurement of abdominal subcutaneous tissue thickness in predicting fetal macrosomia (weight > 4,000 g). METHODS: Abdominal subcutaneous tissue thickness was measured sonographically in 133 term fetuses. All studied fetuses were delivered within 72 hours after the measurements were taken. RESULTS: One hundred thirteen fetuses were normal size, and 20 were macrosomic. The fetal abdominal subcutaneous tissue thickness ranged between 3 and 18 mm in all fetuses, with a mean measurement of 8.4 +/- 2.7 mm (standard deviation). The mean tissue thickness differed significantly between normal and macrosomic fetuses (7.0 mm versus 12.4 mm, respectively; p < 0.0001). There was a significant positive correlation between the abdominal subcutaneous tissue thickness and the birth weight (r = 0.67, p < 0.0001). The negative predictive value for a range of cut-off points between 8 and 13 mm varied between 84.3% and 100% (for prevalence rates of macrosomia of 5-25%). However, the positive predictive value was less than 50% for cut-off values below 11 mm. CONCLUSIONS: Sonographic measurement of the subcutaneous tissue thickness of the fetal abdomen is useful for ruling out macrosomia.

Abdominal Muscles↗
PubMed1997

Prenatal diagnosis of pseudothalidomide syndrome in consecutive pregnancies of a consanguineous couple.

Pseudothalidomide syndrome is a rare autosomal recessive condition characterized by tetraphocomelia, craniofacial abnormalities and postnatal growth restriction. We report the prenatal sonographic findings of pseudothalidomide syndrome in three consecutive pregnancies of a consanguineous couple. In the last pregnancy, the correct diagnosis was made sonographically at 11 weeks of pregnancy. The combination of transabdominal and transvaginal ultrasound examinations revealed a large cystic hygroma extending over the lower back. The lower extremities were markedly shortened with no identifiable bones below the level of the femora. The humeri on both sides were shortened; ulnae were small with no identifiable radii. The pregnancy was terminated by dilatation and curettage and diagnosis confirmed at 12 weeks of pregnancy. In conclusion, fetuses with pseudothalidomide syndrome may exhibit characteristic findings in the first trimester of pregnancy which can be detected using ultrasound.

Abnormalities, Multiple↗
PubMed1997

Jugular venous blood flow velocity waveforms in human fetuses between 20 and 42 weeks of pregnancy.

BACKGROUND: The goal of the study was to measure the blood flow parameters of the fetal internal jugular vein during the second half of normal pregnancy using Doppler ultrasound. METHODS: Jugular blood flow was analyzed in 95 normal singleton fetuses between 20 and 42 weeks gestation. Color and pulsed Doppler ultrasound was used to obtain jugular venous waveforms at the level of the mid-neck. Peak velocities, ratios of velocities, and time-averaged maximum velocities were measured. RESULTS: Jugular venous waveforms in healthy fetuses consist of three phases--the first forward peak occurs during ventricle systole; the second forward peak occurs during early diastole and the third peak occurs during atrial contraction. Forty-eight percent of the fetuses demonstrated absent flow during atrial contraction; 32% of fetuses demonstrated forward flow during atrial contraction and finally 20% of fetuses demonstrated flow reversal during atrial contraction. CONCLUSIONS: The reported jugular venous profile may serve as a foundation for future studies of jugular blood flow in high risk fetuses.

Adult↗
PubMed1996

Diurnal non-stress test variations in healthy term fetuses. A call for evening appointments for fetal testing.

OBJECTIVE: The null hypothesis is that the time of day during which non-stress testing is performed does not influence the reactivity of the test. STUDY DESIGN: Fetal heart rate (FHR) monitoring was performed in 65 healthy term fetuses at 09:00, 14:00 and 21:00 h, in a quiet room exposed to daylight 2 h after maternal meals. Each session lasted 20 min. Smoking mothers were excluded. Statistical analysis was performed using a double-tailed t-test. RESULTS: Diurnal non-stress test (NST) variations exist and are manifested by a higher incidence of a reactive NST at 21:00 h compared to a 09:00 h assessment, and an increased number and longer duration of accelerations during a 20-min observation period at 21:00 h compared to a 09:00 h assessment. CONCLUSIONS: Evening appointments for fetal assessments may eliminate the need for additional tests due to the decreased incidence of nonreactive NSTs. These in turn will decrease both maternal anxiety and the expense of further testing.

Appointments and Schedules↗
PubMed1996

Fetal hydrops secondary to human parvovirus infection in early pregnancy.

Parvovirus B19 infection has been associated with fetal anaemia, hydrops, and in some cases demise. Most of the reported cases of fetal hydrops were detected in second-trimester fetuses. We report a series of three cases in which human parvovirus infection was associated with hydropic changes at an earlier gestational age. Spontaneous resolution of hydrops occurred in all fetuses. A greater understanding of the natural history of human parvovirus infection is needed prior to deciding on the mode of therapy (conservative management versus in utero fetal therapy).

Adult↗
PubMed1996

Size disparity of the choroid plexuses of the lateral ventricles: prenatal diagnosis and neonatal outcome.

Fetal choroid plexuses have attracted the attention of perinatologists and geneticists because of the reported association between intrachoroid cysts and chromosomal abnormalities. This report deals with another variation in choroid plexus sonographic appearance-size variation. Sonographic follow-up results as well as neonatal outcome were analysed in five fetuses with these findings. All fetuses had a normal karyotype. Disparate choroid plexuses were not associated with other structural anomalies. None of the fetuses developed ventriculomegaly.

Choroid Plexus↗
PubMed1995

Isolated fetal hydronephrosis: beware the effect of bladder filling.

The aim was to assess the role that fetal bladder size has in the determination of fetal hydronephrosis. Forty-three fetuses were evaluated for fetal hydronephrosis in the second trimester of pregnancy. Anteroposterior measurements of the renal pelvis were obtained with a full bladder and again when the bladder emptied in each fetus. Statistical analysis was performed using the Spearman rank order correlation coefficient to assess the relationship between bladder status and renal dilation. The anteroposterior size of the fetal renal pelvis diminished from 6.8 +/- 1.8 mm on a full bladder scan to 4.5 +/- 1.6 mm when the bladder was emptied (P < 0.001). Fifty-three per cent of the fetuses whose renal pelvic measurements were 5 mm or more on a full bladder scan had normal-appearing renal pelvises when their bladders emptied. The status of the fetal bladder should be considered when evaluating fetal hydronephrosis.

Diagnostic Errors↗
PubMed1995

The application of color Doppler technology to the study of fetal swallowing.

OBJECTIVE: To investigate the mechanics of fetal swallowing using color Doppler technology. METHODS: The fetal face and a profile were imaged sagitally in ten fetuses at 36-41 weeks' gestation. Color-flow Doppler signals were superimposed on each gray-scale image to assess the direction and location of amniotic fluid (AF) flow with respect to anatomic structures of the fetal upper gastrointestinal and respiratory tracts during the act of swallowing. Further analysis of fetal swallowing movements was performed by a review of the ultrasonography videotapes at a slow speed. RESULTS: An initial stage of fetal swallowing was characterized by two to six sucking movements and the introduction of an AF bolus into the oral cavity. The soft palate superiorly and the tongue posteriorly and inferiorly obstructed the further flow of AF. The final stage of swallowing was characterized by low-frequency tongue movements, upward laryngeal and epiglottic movements, and narrowing of the lumen of the pharynx, directing the fluid bolus caudally. However, some AF was directed into the nasopharynx as well as the trachea. CONCLUSION: The swallowing pattern in the term fetus differs from that in the infant and adult, in that the oral and pharyngeal phases appear to be less completely developed.

Deglutition↗
PubMed1995

Natural history of echogenic foci within ventricles of the fetal heart.

Echogenic foci within the fetal heart have been reported in association with cardiac tumors and chromosomal abnormalities. They have been observed also as a normal variant of cardiac development. The goal of this study was to analyze the frequency, distribution and natural history of echogenic foci within the fetal heart. A total of 1139 patients referred for targeted ultrasound were studied. Patients with positive findings (presence of the echogenic foci) were referred for serial fetal echocardiographic examinations at 26-28 weeks and 34-36 weeks of pregnancy. Neonatal follow-up examinations were performed within the first 3 months of life in 27 cases. Ventricular echogenic foci were seen in 3.6% of fetuses. The locations of the echogenic foci were as follows: left ventricle, 92.8%; right ventricle, 4.8%; both ventricles, 2.4%. All fetuses had a normal karyotype. Echogenic foci remained present in all infants who underwent echocardiographic examination within the first 3 months of life. Echogenic intracardiac foci probably represent a normal variant of the development of papillary muscles and chordae tendinae.

Adult↗
PubMed1995

Continuous fetal heart rate monitoring during bone marrow harvesting in pregnancy.

To date, our computer-assisted search failed to report any case involving a gravid patient donating her bone marrow for harvesting. It is known that bone marrow harvesting causes a significant decrease in the donor's blood volume and therefore this can be potentially detrimental to both the mother and the fetus. We report the first case of the gravid donor in which fetal heart rate (FHR) during bone marrow harvesting has been studied. Decreased beat to beat variability and disappearance of accelerations were noted. The FHR returned to normal shortly after the procedure was terminated.

Adolescent↗
PubMed1994

Prenatal diagnosis of focal nodular hyperplasia of the liver.

A case of focal nodular hyperplasia of the liver presenting in a 36-week-old fetus is reported. The tumour appeared on antenatal ultrasound as a 4.0 cm x 3.0 cm x 2.7 cm hypoechoic mass at the periphery of the right lobe of the liver. Colour Doppler imaging showed it to have prominent vascularity. Postnatally, sonography confirmed the presence of a vascular mass within the liver. The tumour was removed at laparotomy and was diagnosed as an area of focal nodular hyperplasia on histopathological examination.

Adult↗
PubMed1994

First-trimester diagnosis of duodenal atresia.

The earliest diagnosis of duodenal atresia, at 14 weeks of pregnancy, is reported. An attempt to diagnose this entity should be considered in the first trimester, which will allow ample time for counseling, genetic testing, and decision making.

Adult↗