Biomedical subjects

Denyse Rinfret

Publications and source records attributed to Denyse Rinfret.

4 recordsLinked to original sources

PubMed2005

Prediction of growth discordance in twins with the use of abdominal circumference ratios.

OBJECTIVE: The purpose of this study was to assess the accuracy of sonographic prediction of twin birth weight discordance using the abdominal circumference ratio. STUDY DESIGN: This was a prospective cohort of diamniotic twin gestations that underwent serial ultrasound examinations every 2 to 4 weeks from 11 to 38 weeks of gestation. Birth weight discordance was defined as > or =25% difference in birth weight, relative to the larger twin. The sensitivity, specificity, and predictive values for the abdominal circumference ratio were assessed for the prediction of growth discordance. RESULTS: Of 503 diamniotic twin pregnancies, 64 pregnancies (12.7%) had discordant fetal growth. The abdominal circumference ratio could be measured consistently throughout gestation in 100% of twin pairs. Receiver operating curve analysis showed that the abdominal circumference ratio was a good predictor of birth weight discordance (area under the curve = 0.80). An abdominal circumference ratio cutoff of 0.93 yielded a sensitivity and specificity of 61% and 84%, respectively. CONCLUSION: Twin birth weight discordance may be predicted at any gestational age with an abdominal circumference ratio <0.93.

Abdomen↗

PubMed2005

Should we offer expectant management in cases of severe preterm preeclampsia with fetal growth restriction?

OBJECTIVE: The purpose of this study was to assess maternal and fetal morbidity and death in cases of severe preterm preeclampsia that were managed expectantly. STUDY DESIGN: It is a retrospective study that included 155 singleton pregnancies with severe preeclampsia at <34 weeks of gestation that were managed expectantly over a 10-year period. Perinatal outcomes of both mother and fetus were stratified according to gestational age and the severity of fetal growth restriction < or =3th percentile, 4th to 5th percentile, >5th to10th percentile, and >10th percentile. RESULTS: The mean gestational age at admission was 30.2 +/- 2.4 weeks (range, 23.9-34.0 weeks). The mean latency period was 5.3 +/- 5.2 days, with a perinatal mortality rate of 3.9%. Gestational age of <30 weeks of gestation was the strongest variable that affected perinatal outcome, whereas fetal growth restriction played a marginal role. CONCLUSION: Expectant management is recommended strongly in fetuses at <30 weeks of gestation, irrespective of fetal growth restriction. Delivery should be considered at >30 weeks of gestation.

Adolescent↗

PubMed2005

Persistance of adverse obstetric and neonatal outcomes in monochorionic twins after exclusion of disorders unique to monochorionic placentation.

OBJECTIVE: This study was undertaken to assess obstetric and neonatal outcomes in dichorionic twins and monochorionic-diamniotic twins after exclusion of twin-to-twin transfusion syndrome and twin reversed arterial perfusion sequence. STUDY DESIGN: Data from a tertiary center were collected in twin gestations between 1994 and 2002. Chorionicity was defined by standard echographic criteria and placental examination at delivery. Neonatal outcomes were compared between monochorionic and dichorionic gestations. RESULTS: This study included 503 women: 378 (75%) dichorionic and 125 (25%) monochorionic twin gestations. Monochorionic twin gestations had a higher risk of preterm deliveries between 30 and 34 weeks' gestation than pregnancies with dichorionic twins (P < .01). Monochorionic twins had a higher number of birth weight less than 10th percentile (P < .001) discordancy 25% or greater (P < .02), admission to neonatal intensive care unit (P < .03), and intraventricular hemorrhage grade 3 and 4 (P < .007) than dichorionic twins even after adjusting for gestational age. CONCLUSION: Monochorionic diamniotic twins have a higher risk of perinatal complications than dichorionic twin gestations, even after exclusion of disorders unique to monochorionic placentation.

Adult↗

PubMed2003

Sublingual nitroglycerin versus placebo as a tocolytic for external cephalic version: a randomized controlled trial in parous women.

OBJECTIVE: The purpose of this study was to evaluate the efficacy of sublingual nitroglycerin as a tocolytic agent for external cephalic version in parous women. STUDY DESIGN: A double-blinded randomized controlled trial was performed. Patients with parity of >or=1 at 36 to 40 weeks of gestation who were eligible for external cephalic version were included. Patients were randomized to receive either two sublingual sprays of 400 mug of nitroglycerin or two sprays of placebo 3 minutes before the trial of external cephalic version. Rates of successful external cephalic version and side effects were compared between groups. RESULTS: Of 99 patients in the study, 50 patients received sublingual nitroglycerin, and 49 patients received placebo. There were no differences in maternal age, gestational age, estimated fetal weight, amniotic fluid index, and placental location between the two groups. The success rate of external cephalic version was 48% in the nitroglycerin group compared with 63% in the placebo group (P=.13). There was a higher incidence of headaches in the nitroglycerin group (42% vs 4%, P<.001). CONCLUSION: Sublingual nitroglycerin was associated with a higher rate of headache and did not improve the rate of successful external cephalic version.

Administration, Sublingual↗