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Biomedical subjects

D J Nochimson

Publications and source records attributed to D J Nochimson.

At least 55 records · Page 3Linked to original sources
PubMed1986

Qualitative amniotic fluid volume versus amniocentesis in predicting infection in preterm premature rupture of the membranes.

Qualitative amniotic fluid volume assessment and amniocentesis were performed on admission in 54 patients who presented with premature rupture of the membranes and no clinical signs of infection or labor. Comparison of these two methods in predicting infection outcome--as reflected by the development of clinical amnionitis and/or neonatal sepsis--suggests them to have the same efficacy in predicting infection outcome in patients with premature rupture of the membranes. Qualitative amniotic fluid volume was found to have sensitivity 50%, specificity 92.8%, positive predictive value 66.6%, and negative predictive value 86.6%; amniocentesis was found to have sensitivity 58.3%, specificity 88%, positive predictive value 58.3%, and negative predictive value 88%. The use of ultrasonically estimated amniotic fluid volume could replace or be used in addition to amniocentesis in identifying patients with ruptured membranes at particular risk for developing infection.

Adult↗
PubMed1986

Value of fetal ponderal index in predicting growth retardation.

Fetal ponderal indexes were calculated by ultrasound examination and compared with the neonatal ponderal indexes in 113 pregnancies. The relationship between the fetal and neonatal ponderal indexes throughout gestation is described. The fetal ponderal index also was evaluated as a predictor of intrauterine growth retardation (IUGR) and was found to have sensitivity and specificity of 76.9 and 82%, respectively. These data suggest that the fetal ponderal index could be used to rule out the diagnosis of IUGR with reasonable accuracy (negative predictive value 96.4%).

Body Weight↗
PubMed1986

Amniocentesis with premature rupture of membranes.

Transabdominal amniocentesis was used in 73 consecutive, referred patients with premature rupture of membranes and no clinical signs of infection or labor. Positive Gram stain or positive culture of obtained amniotic fluid was used as an indication for delivery. The outcome of pregnancy in this group of patients was compared with the outcome of a historic control group of 73 patients managed conservatively without amniocentesis. Clinical amnionitis and low five-minute Apgar scores occurred significantly less often in the study than in the control group; however there was no difference in the frequency of neonatal infection, one-minute Apgar score, cord blood pH, or perinatal mortality between the two groups.

Amniocentesis↗
PubMed1986

Fetal biophysical profile versus amniocentesis in predicting infection in preterm premature rupture of the membranes.

A comparison between daily fetal biophysical profile determinations and amniocentesis (for Gram stain and culture) was studied prospectively in 58 patients who presented with preterm premature rupture of the membranes and no apparent infection or labor. The efficacy of these two methods in predicting infection outcome--as reflected by the development of clinical amnionitis and/or neonatal sepsis--was determined. These data suggest that daily fetal biophysical profile assessment is superior to amniocentesis in predicting infection outcome in these patients. The use of frequent biophysical profile determinations should replace amniocentesis in selecting those patients with premature rupture of the membranes who are more likely to develop infection with associated fetal/neonatal sepsis.

Amniocentesis↗
PubMed1985

Intrapartum ultrasound diagnosis of nuchal cord as a decisive factor in management.

Reported is the case of a patient who presented in labor with a fetal heart rate tracing that showed repetitive variable decelerations. Time lapse between presentation and delivery was minimized by the ultrasound confirmation of a nuchal cord. Delivery by cesarean section was elected rather than making further attempts at maternal repositioning.

Adult↗
PubMed1985

Polyhydramnios and obstructive renal failure: a case report and review of the literature.

Described is a pregnancy complicated by pregnancy-induced hypertension, polyhydramnios, and obstructive renal failure due to an overdistended uterus. A review of the literature disclosed that only five such cases have been reported previously. Fetal outcome was generally related to the duration of gestation at the onset of polyhydramnios.

Acute Kidney Injury↗
PubMed1985

The fetal biophysical profile in patients with premature rupture of the membranes--an early predictor of fetal infection.

A modified fetal biophysical profile (nonstress test, fetal movements, fetal breathing movements, fetal tone, amniotic fluid volume, and placental grading) was serially assessed in 73 patients who presented with premature rupture of the membranes and were not in labor. The last study before delivery was compared with the outcome of pregnancy. The relationships between individual variables and combinations of variables (biophysical scoring) and the outcome of pregnancy--as reflected by the development of chorioamnionitis and/or neonatal sepsis--were determined. These data suggest that the fetal biophysical profile is a useful tool for evaluating patients with rupture of the membranes. Rupture of the membranes by itself does not alter the biophysical scoring of the healthy fetus; however, a low biophysical score (less than or equal to 7) was a good predictor of impending fetal infection in patients with premature rupture of the membranes.

Apgar Score↗
PubMed1985

Intrapartum fetal heart rate monitoring of the extremely premature fetus.

When cesarean section is not warranted because of extreme prematurity, continuous electronic fetal heart rate monitoring during the intrapartum period and in utero resuscitation of the distressed fetus are indicated, especially in cases of borderline fetal viability. Two cases are presented to illustrate the benefit of such measures when fetal distress occurs and the fetus is judged to be too small for operative intervention.

Adult↗
PubMed1985

Use of the femur length to estimate fetal weight in premature infants: preliminary results.

Current techniques for estimating fetal weight in utero use equations containing biparietal diameter and abdominal circumference measurements. When a biparietal diameter cannot be obtained or its technical quality is poor, this technique is hindered. In this study, the use of the fetal femur length and abdominal circumference in estimating fetal weight was investigated. A new formula for estimation of fetal weight with a random error of 13.0 per cent is described.

Abdomen↗
PubMed1985

Ultrasound fetal thigh-calf circumferences and gestational age--independent fetal ratios in normal pregnancy.

The growth of the sonographically measured fetal thigh and fetal calf circumferences was studied during normal pregnancy. The normal range of fetal thigh and fetal calf circumferences for each week of pregnancy was determined from 20 to 41 weeks. The ratios of the ultrasonically measured fetal femur length to thigh circumference (expressed as femur length/thigh circumference X 100) and fetal tibia length to calf circumference (expressed as tibia length/calf circumference X 100) were also determined. These ratios were found to be relatively constant, with normal ranges after 20 weeks of 51.8 +/- 7.8 and 57.6 +/- 9.4 (mean +/- 2SD) respectively. The applications of these new fetal parameters in the evaluation of abnormal fetal growth patterns are discussed. It is suggested that these ratios should be used in evaluating fetal growth in high-risk patients who present late in pregnancy with unknown dates.

Anthropometry↗
PubMed1985

Fetal atrial flutter and X-linked dominant vitamin D-resistant rickets.

A pregnancy, complicated by hypophosphatemic familial rickets (vitamin D-resistant rickets) of a female fetus, associated with atrial flutter and congestive heart failure is presented. Upon review of the literature, only 22 cases of fetal atrial flutter have been reported. The association between hypophosphatemic familial rickets and atrial flutter has not yet been described.

Adult↗
PubMed1985

Degree of oligohydramnios and pregnancy outcome in patients with premature rupture of the membranes.

Amniotic fluid volume was serially assessed by real-time ultrasound in 90 patients who presented with premature rupture of the membranes (PROM) and not in labor. The degree of oligohydramnios was correlated to the outcome of pregnancy, as reflected by pregnancy prolongation, intrapartum fetal heart rate patterns consistent with umbilical cord compression, cesarean section rate, fetal distress, infection, and perinatal mortality rate. These data suggest that in patients with PROM the degree of oligohydramnios is positively correlated with unfavorable pregnancy outcome.

Amniotic Fluid↗
PubMed1985

Fetal liver ultrasound measurements during normal pregnancy.

The ultrasonically determined growth of the fetal liver during normal pregnancy is presented. The normal range of fetal liver sizes for each week of pregnancy from 20 weeks' gestation to term was determined. A linear relationship between fetal liver and abdominal circumference measurements also is described. Value and potential applications of this new fetal parameter are discussed.

Abdomen↗
PubMed1985

Three fetal ponderal indexes in normal pregnancy.

The relationship of three different fetal ponderal indexes was studied in 116 normal pregnancies between 20 and 41 weeks. All three fetal ponderal indexes were found to be independent of gestational age. Throughout normal gestation, the femur length to abdominal circumference ratio X 100 was found to be 22.3 +/- 2.4 (mean +/- 2 SD), the tibia length to abdominal circumference ratio X 100 19.3 +/- 2.2 (mean +/- 2 SD), and the femur plus tibia length to abdominal circumference ratio X 100 41.6 +/- 4.2 (mean +/- 2 SD). The clinical applications of the different fetal ponderal indexes in evaluating fetal growth are discussed. Because they are independent of gestational age, the fetal ponderal indexes should prove most useful in evaluating fetal growth in high-risk patients with unknown dates.

Body Weight↗
PubMed1984

Zinc transport in pregnancy.

Although the importance of zinc nutrition during pregnancy has been well recognized, there have been few studies of zinc transport in maternal or fetal sera. We examined total serum zinc levels as well as zinc associated with its major transport proteins, albumin and alpha 2-macroglobulin, prospectively in 46 women during gestation and in 27 of their infants at term. In five women who developed preeclampsia during the third trimester, the mean total serum zinc level at 6 to 14 weeks was decreased by 14% compared to control values (p less than 0.05). Fetomaternal differences between the zinc transport proteins support the concept that each may have a specific role(s) in zinc homeostasis which is regulated to a greater extent by metabolic factors than by dietary zinc intake alone.

Adolescent↗