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Biomedical subjects

D Abramovici

Publications and source records attributed to D Abramovici.

9 recordsLinked to original sources
PubMed1999

A randomized comparison of oral misoprostol versus Foley catheter and oxytocin for induction of labor at term.

OBJECTIVE: We sought to compare the efficacy and safety of oral misoprostol administered to patients with the efficacy and safety in a control group treated with a Foley catheter and oxytocin for induction of labor. STUDY DESIGN: Two hundred patients requiring induction of labor at term with a Bishop score of </=5 were randomized to receive oral misoprostol or a cervical Foley catheter plus oxytocin. Patients in the misoprostol group received 50 microg at 4-hour intervals for a maximum of 6 doses or until an adequate contraction pattern developed. Those in the control group had a Foley catheter inserted in the cervix, whereas oxytocin was administered intravenously by a standard incremental infusion protocol to a maximum dose of 36 mU/min. RESULTS: In multiparous patients the percentage delivered of their neonates within 24 hours and the median induction-to-delivery times were similar in the 2 groups. In nulliparous patients, however, delivery within 24 hours was significantly less likely in the misoprostol group (53.4% vs 82. 5%; P <.001), and the median induction-to-delivery time was longer (23.3 hours vs 17.2 hours; P <.01). There were no differences in the incidence of meconium, chorioamnionitis, low Apgar scores, or cesarean delivery. The incidence of hyperstimulation was higher in the oxytocin-Foley group (4.1% vs 13.1%; P =.02). CONCLUSION: Oral misoprostol is as effective as oxytocin-Foley catheter for inducing labor in multiparous women. Misoprostol appears less efficacious in nulliparous patients.

Administration, Oral↗
PubMed1999

Neonatal outcome in severe preeclampsia at 24 to 36 weeks' gestation: does the HELLP (hemolysis, elevated liver enzymes, and low platelet count) syndrome matter?

OBJECTIVE: Our purpose was to compare neonatal outcome after preterm delivery of infants whose gestation was complicated by the HELLP (hemolysis, elevated liver enzymes, and low platelet count) syndrome, partial HELLP syndrome, or severe preeclampsia. STUDY DESIGN: We reviewed the maternal and neonatal charts from 269 consecutive pregnancies complicated by the HELLP syndrome or severe preeclampsia managed at our perinatal center. The HELLP syndrome was defined by previously published laboratory criteria. Viable pregnancies were divided into 3 groups: HELLP syndrome, partial HELLP syndrome (at least 1, but not all 3, features of the HELLP syndrome), and severe preeclampsia (no features of the HELLP syndrome). Results were compared by means of chi2 analysis and Student t test where appropriate. Logistic regression was used to evaluate outcome variables at different gestational ages. RESULTS: There were no significant differences in complications among the 3 groups at each gestational age. There was, as expected, a significant decrease in morbidity and mortality rates with advanced gestational age. CONCLUSIONS: In severe preeclampsia, neonatal morbidity and death are related to gestational age rather than to the presence or absence of the HELLP syndrome. Whether expectant management is safe for women with the HELLP syndrome requires further study.

Adult↗
PubMed1998

Infant with midline thoracoabdominal schisis and limb defects.

An infant presented with multiple congenital anomalies including a midline thoracoabdominal defect, absence of the sternum, ectopia cordis, right diaphragmatic hernia, right anophthalmia, left microphthalmia, incomplete bilateral cleft lip, and various limb defects including ectrodactyly of the right hand and left foot, and phocomelia of the right lower extremity. The infant expired soon after birth. The radiological findings included absence of the sternum, 11 right-sided ribs, absence of the middle third of the right clavicle, opaque right hemithorax, hypoplastic right tibia, absent right fibula and foot, and ectrodactyly of the right hand and left foot. In addition, the autopsy revealed two distinct diaphragmatic defects, an anterior midline defect of the diaphragm beneath the ectopic heart, and a large Bochdalek hernia, with abdominal contents in the chest. Our case has overlapping features with conditions such as thoracoabdominal syndrome, pentalogy of Cantrell, and limb-body wall complex, but the concurrence of midline body wall defect and ectrodactyly has not been described previously.

Abdomen↗
PubMed1995

Bilateral ectopic pregnancy. A case report.

Bilateral ectopic pregnancy is a rare phenomenon. It has been 76 years since the first published report of a case of bilateral ectopic pregnancy. Since then about 200 cases have been reported in the literature; we report a case here.

Adult↗
PubMed1991

Fetal and uteroplacental flow velocity waveforms and placental grading.

Doppler studies were performed on umbilical, fetal internal carotid, and arcuate arteries within 36 to 40 weeks of gestation in 85 women (66 with healthy pregnancies and 18 complicated by growth retardation, and results were analyzed by calculating the pulsatility index. In each case the placenta was examined and graded sonographically. No significant correlation was found between pulsatility index in fetal and uteroplacental vessels and placental grading in normal pregnancies. This suggests that tissue changes responsible for the echogenicity of maturing placenta are not directly related to vascular impedance of the placental vascular bed.

Adult↗
PubMed1989

Leiomyoma of the fetal membranes: report of a case.

A leiomyoma of the fetal membranes was incidentally discovered on examination of a spontaneously expulsed placenta following an uneventful pregnancy and delivery of a healthy neonate. Perusal of the literature uncovered only a single report of a placental leiomyoma.

Adult↗
PubMed1989

Burn resuscitation with a low-volume plasma regimen--analysis of mortality.

The results of a mortality analysis from the Burn Center in Rambam Medical Center, Haifa, Israel, over a 5-year period are presented. The management of severe burns during the 'shock' period included a low-volume resuscitation formula consisting mainly of plasma and a small volume of crystalloid solution. The efficacy of burn management was assessed by probit analysis of the mortality data. We derived the percentage of body surface area burned associated with a 50 per cent probability of death (LA50) for four different age groups. The LA50 values obtained were compared to those obtained from other series; they compared favourably, demonstrating that resuscitation with low volumes consisting mainly of colloids may reduce complications associated with fluid overloading and therefore improve the LA50.

Adolescent↗
PubMedDate not supplied

Human gonadotropin therapy: hormonal and ultrasonographic characteristics of conceptual and nonconceptual cycles in the same women.

A retrospective analysis was carried out to assess hormonal and sonographic characteristics of 52 conceptual (P-cycles) and 53 nonconceptual (F-cycles) gonadotropin treatment cycles in the same women. In the P-cycles, an exponential E2 pattern was observed up to the day of hCG (human chorionic gonadotropin) administration (day 0). In the F-cycle group, a similar pattern was observed till day (-1), and then levels plateaued. Forty-two (80.9%) of the pregnancies were achieved when the active phase was 6 +/- 1 days; seven pregnancies (14.8%) occurred when the active phase was more than 7 days. Only one of these pregnancies was a singleton viable pregnancy (P less than .05). It is, therefore, postulated that 6 +/- 1 days rising E2 and exponential E2 rise pattern up to the day of hCG are the two main monitoring variables leading to the highest percentage of viable singleton or twin pregnancies in hMG-stimulated cycles.

Adult↗