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Biomedical subjects

B Petrikovsky

Publications and source records attributed to B Petrikovsky.

At least 19 recordsLinked to original sources
PubMed2005

Soft forceps.

OBJECTIVE: The risk of maternal and fetal trauma and, chiefly, the fear of law suits, have contributed to a significant decline in rates of forceps-assisted deliveries and an increase in rates of cesarean sections, especially in the United States. Our experience with gas-sterilized forceps blades covered with a soft rubber coating--the "soft" forceps--is described. METHOD: Ninety-six women who required a forceps-assisted delivery for standard indications were randomly allocated to 2 groups. There were 51 women in the regular forceps group and 45 women in the soft forceps group. Low forceps delivery with a Simpson instrument was used in all cases. The groups were compared for fetal injury. RESULTS: The rates of severe facial abrasion and minimal marking were 4.1% and 61%, respectively, in the regular forceps group and 1.9% and 34% in the soft forceps group. CONCLUSION: The soft forceps may reduce the rates of neonatal facial abrasion and skin bruises. The forceps should be further perfected, as well as vacuum extractors; they should both continue to be part of the obstetrician's armamentarium.

Contusions↗
PubMed1999

Intra-amniotic bleeding and fetal echogenic bowel.

OBJECTIVE: To assess the relationship between intra-amniotic bleeding and fetal echogenic bowel. METHODS: Comprehensive fetal ultrasound examinations were done before and 12 hours after fetal transfusions. Follow-up ultrasound examinations were done weekly in 28 fetuses with intra-amniotic bleeding. Hyperechogenic bowel was diagnosed when the echogenicity of fetal bowel was similar to that of bone. Postpuncture bleeding was identified when a stream of echogenic material from the cord into the amniotic space was seen, lasting at least 60 seconds. RESULTS: None of the fetuses had echogenic bowel before initial transfusions. Intra-amniotic bleeding was followed by bowel echogenicity in seven of 28 fetuses within the first 12 hours after bleeding episodes. Echogenic bowel remained in five fetuses 2 weeks after the bleeding episodes. In three fetuses, echogenic bowel was still seen 4 weeks later. CONCLUSION: Intra-amniotic bleeding can lead to echogenic bowel.

Adult↗
PubMed1999

Lateral nasal proboscis: antenatal diagnosis and counseling.

BACKGROUND: Lateral nasal proboscis is a rare anomaly resulting in incomplete formation of one side of the nose and other variable abnormalities in the adjoining regions of the face, without associated brain malformations. We report a case diagnosed antenatally and confirmed after birth of the infant. CASE: A 32-year-old white gravida 2 para 1 was referred for a comprehensive fetal ultrasound at 30.5 weeks to evaluate a facial anomaly seen on an ultrasound done to evaluate decreased fetal movements. A fingerlike projection was seen in the left inner eye area with visualization of one nostril and a small nose. After a spontaneous delivery at term, a 3845-g healthy female infant with lateral nasal proboscis and other locally associated anomalies was born and is doing well at 9 months. Reconstructive surgery was done at 3 and 6 months. CONCLUSION: Accurate antenatal diagnosis of lateral nasal proboscis is possible with ultrasound, which is important because its prognosis and management are different from other types of proboscides.

Adult↗
PubMed1999

Fetal yawning activity in normal and high-risk fetuses: a preliminary observation.

OBJECTIVE: To study yawning activity in healthy fetuses and in fetuses at high risk. METHODS: Yawning activity was studied in 16 healthy and 22 high-risk fetuses. Studies were performed in the postprandial state at 09.00 and 12.00 in a quiet room with the woman in the lateral recumbent position. All ultrasound examinations were performed using a 3.5-MHz Acuson 128 PX curvilinear probe. Fetal lips, mouth, tongue, pharynx, larynx, trachea and esophagus were surveyed in serial coronal and sagittal planes. All fetal mouthing movements were analyzed by a review of the videotape in slow motion. RESULTS: In both normal and high-risk fetuses, yawning was represented by isolated mouthing movements and consisted of slow opening of the mouth with simultaneous downward movements of the tongue. This phase occupied 50-75% of the yawning cycle. After reaching its maximum opening, the mouth remained wide open for 2-8 s and returned to its resting position within seconds. Growth-restricted fetuses demonstrated yawning patterns consisting of isolated yawns similar to those seen in healthy fetuses. Unusual bursts of fetal yawning activity were recorded in anemic fetuses. CONCLUSION: Yawning activity in anemic fetuses may represent a compensatory process to increase venous return to the heart.

Female↗
PubMed1998

Clinical significance of echogenic amniotic fluid.

PURPOSE: This study aimed to determine the clinical significance of echogenic amniotic fluid. METHODS: We prospectively studied 19 twin pregnancies in which the amniotic fluid in 1 sac was anechoic and that in the other sac was echogenic. Morphologic characteristics of amniotic fluid were assessed from samples taken at amniocentesis or upon delivery within 48 hours after sonographic examination. RESULTS: In twins with echogenic amniotic fluid, assessment revealed clear fluid in 6 cases (32%), vernix caseosa in 12 (63%), and meconium in 1 (5%). In co-twins with anechoic amniotic fluid, assessment revealed clear fluid in 9 cases (47%), vernix caseosa in 6 (32%), and meconium in 4 (21%). CONCLUSIONS: Echogenic amniotic fluid on prenatal sonography is not predictive of meconium.

Adult↗
PubMed1998

Prenatal diagnosis of intra-atrial cardiac echogenic foci.

Intra-atrial echogenic foci were detected in 3 out of 15,706 fetuses (prevalence 0.019 per cent). In all cases, they were located in the right atrium. Normal chromosomes and negative TORCH titres were observed in all affected cases. Fetuses with intra-atrial echogenic foci demonstrated adequate intra-uterine growth and had normal neonatal outcome. Intra-atrial echogenic foci seem to represent a normal variant of fetal cardiac development.

Echocardiography↗
PubMed1997

Practical guidelines for antepartum fetal surveillance.

Antepartum fetal assessment is used in pregnancies at high risk for perinatal morbidity and mortality. Current testing options include the fetal movement count, the nonstress test, the contraction stress test and the biophysical profile. Vibroacoustic stimulation is a useful adjunctive procedure. All of these modalities have limitations. A strict protocol for antepartum fetal surveillance that is applicable to all patients is not possible. However, a testing approach based on general principles and guidelines can be followed.

Female↗
PubMed1996

Fetal pharyngeal distention--is it a normal component of fetal swallowing?

Fetal swallowing is one of the main mechanisms of amniotic fluid circulation. Swallowing mechanisms were studied in 34 healthy fetuses using modern ultrasound technology. The fetal lips and mouth, as well as tongue, pharynx, larynx, trachea and esophagus were surveyed in serial sagittal planes. Fetal swallowing movements were recorded and subsequently analyzed from the videotapes. All neonates were born at term in a satisfactory condition. Twenty-nine infants were breastfed, and five were bottle fed. No feeding problems were reported in these neonates. In 85% of fetuses, swallowing activity started with suckling movements followed by wide opening of the mouth. Next, low frequency tongue movements propelled the fluid bolus into the hypopharynx. In 15% of fetuses, this activity was associated with prolonged pharyngeal dilatation. Prolonged pharyngeal dilatation does not signify fetal neurological compromise as judged by good neonatal outcome and probably represents a normal variant of fetal swallowing.

Amniotic Fluid↗
PubMed1996

Prenatal diagnosis and clinical significance of hypoplastic umbilical artery.

This study reports the maternal, fetal, and neonatal outcomes in cases with hypoplastic umbilical artery. The sonographic finding of a three-vessel umbilical cord showing an artery-to-artery diameter difference of more than 50 per cent was defined as hypoplastic umbilical artery. All fetuses diagnosed with hypoplastic umbilical artery underwent genetic amniocentesis and ultrasound. Fetal, maternal, and neonatal outcomes were analysed. Twelve fetuses with hypoplastic umbilical artery were detected over a 6-year period (1989-1995). Associated abnormalities included trisomy 18 (one case), polyhydramnios (three cases), congenital heart disease (one case), and fetal growth restriction (two cases). Maternal diabetes was detected in four cases. The pregnancy was terminated in one case; one neonate with severe fetal growth restriction expired; and one survived with congenital heart disease. The presence of hypoplastic umbilical artery was associated with increased perinatal morbidity and congenital abnormalities. Diabetes was frequently detected. Fetal surveillance and echocardiography are indicated in cases of hypoplastic umbilical artery.

Female↗
PubMed1996

Prenatal diagnosis of an aneurysm of the right atrium.

Congenital aneurysm of the right atrium was diagnosed in a 17-week fetus. It appeared as an outward bulge of the right atrium which doubled its size. The aneurysm was akinetic. Flow across the atrioventricular valves appeared unobstructed. The fetus had no evidence of cardiac failure. The patient elected to terminate the pregnancy. Autopsy results were confirmatory.

Adult↗
PubMed1996

Unusual appearances of echogenic foci within the fetal heart: are they benign?

Nine fetuses with unusually appearing echogenic foci were selected from a series of 65 fetuses with intracardiac echogenic foci studied at the Fetal Diagnosis and Treatment Unit from January 1994 until February 1996. An echogenic focus or foci were defined as a structure or structures within the fetal heart with echogenicity similar to or greater that that of the surrounding bone. Unusually appearing foci were defined as lesions of unusual size, shape, structure or location. Three fetuses had unusually large echogenic foci, and four had multiple foci in both ventricles. In one fetus, two echogenic foci were very close to each other, creating an impression of a 'double' focus within the left ventricle. In another fetus, three echogenic foci were detected. Follow-up protocol for fetuses with echogenic foci included comprehensive ultrasound, amniocentesis and fetal echocardiography. All studied fetuses had normal karyotype. A fetal echocardiogram failed to reveal congenital heart defects. The neonatal outcome was uneventful in seven out of nine cases; one patient decided to terminate her pregnancy for reasons unrelated to the ultrasound findings, and one delivered prematurely at 34 weeks of pregnancy. In conclusion, we failed to find any correlation between unusually appearing echogenic foci and adverse perinatal outcome.

Echocardiography↗
PubMed1996

Sludge in fetal gallbladder: natural history and neonatal outcome.

Normal and pathological conditions of the fetal gallbladder have been a subject of recent investigation by ultrasonographers. Fetal gallstones are the most common abnormal finding and appear as echogenic foci within the gallbladder. We report a series of five fetuses in whom the gallbladders were filled with sludge which appeared as a pear shape echogenic structure. In the majority of cases, gallbladder sludge mimicked intrahepatic calcification or echogenic bowel. Serial ultrasound examinations of these fetuses revealed good interval growth. The gallbladders remained echogenic and were normal in size in three cases and were moderately enlarged in two. All neonates were born in normal condition with no identifiable malformations. Follow-up was obtained in four infants using abdominal ultrasound. A normal appearing sludge free gallbladder was seen in three neonates at 6 weeks of life and in four infants at 12 weeks. Accurate diagnosis of gallbladder sludge will spare the patient unnecessary work-up and anxiety. The natural history of gallbladder sludge in the fetus is benign in nature and is similar to that of fetal gallstones.

Calcinosis↗