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Biomedical subjects

E Görbe

Publications and source records attributed to E Görbe.

13 recordsLinked to original sources
PubMed2001

[Effectiveness of high-frequency oscillatory ventilation in the treatment of lung hypoplasia in connection with intrauterine growth retardation and maternal pre-eclampsia].

The authors examine in a retrospective study the effectivity of high frequency oscillatory ventilation in group of intrauterine retardated babies with clinical signs of lung hypoplasia. During one year period they treated 12 intrauterine retarded patients with high frequency oscillatory ventilation because of failure of conventional ventilation. The indications were in seven cases the high pCO2 level and in five ones low saturation in spite of surfactant administration. The birth weight of babies were between 770 grams and 2150 grams, and theirs gestational age between 29 and 35 weeks. Four patients died. The causes of death were in two cases severe cardiomyopathy and at two patients intraventricular haemorrhage. Two survivors are suffering of bronchopulmonary dysplasia. They suggest that immediate high frequency ventilation reduces the period of mechanical ventilation and the number of residual picture. They suggest, that lung hypoplasia is an underestimated diagnosis in intrauterine retardated babies. If the cause of respiratory failure in cases complicated with maternal preeclampsia is not only hyaline membrane disease it is necessary to look for signs of lung hypoplasia and to follow the treatment with high frequency oscillatory ventilation.

Adult↗
PubMed2000

[Atypical process of acute disturbance of liver function with severe thrombocytopenia in the third trimester].

The authors diagnosed disturbance of liver-function associated with severe thrombopenia in a pregnant woman in the third trimester. Principally, acute fatty liver of pregnancy can be characterized by existing symptoms, e.g. nausea, vomiting, epigastric pain, jaundice, hyperbilirubinemia, moderately elevated SGOT and SGPT levels, thrombopenia, leukocytosis, low fibrinogen level and disseminated intravascular coagulopathy, but hepatomegaly, purpura and petechia on lower and upper extremities, and high ALP and GGT levels during postpartum period do not confirm suspicion of this diagnosis. The present report draws attention to the difficulties of differential diagnosis of pregnancy-induced elevated liver enzymes diseases associated with low platelets, as there are several identical pathophysiological processes. Although causes and exact pathophysiology of disorders are unknown, similar symptoms during the process of diseases leave the question open whether they are different diseases or whether they are different manifestations of the same disease, and what kind of relationship exists between these diseases and preeclampsia. This case suggests careful evaluation of the whole clinical picture, moreover it is emphasized that prompt, aggressive treatment of hemostatic disturbance and the expeditious delivery can save maternal life.

Acute Disease↗
PubMed1997

[Management of hemodynamically significant fetal arrhythmias].

Between January 1, 1993, and April 30, 1996, authors treated 23 fetuses with severe rhythm disturbances in their Department. The correct diagnosis was made by fetal echocardiography. They had 15 tachyarrhythmic and 8 bradyarrhythmic patients. They found hydrops fetus at 7 patients because of atrial flutter (2 fetuses), supraventricular tachycardia (4 fetuses) and severe bradycardia (1 fetus). They treated successfully 13 patients with antiarrhythmic therapy given to the mother. They had 1 intrauterine death (treated because of bradycardia) and 1 neonatal death (hydropic because of supraventricular tachycardia). The causes of severe bradycardia were maternal antibody (3 fetuses), cardiac malformation (3 fetuses) and large number of blocked atrial extrasystoles. The prognosis of fetal tachycardia is good even in cases of fetal hydrops. The prognosis of bradycardia due to heart abnormalities is poor.

Anti-Arrhythmia Agents↗
PubMed1997

[The effect of the delivery method on the mortality of very low birth weight infants in case of breech presentation].

The authors have investigated the data of 1009 neonates born from breech presentation in the I. Department of Obstetrics and Gynecology of Semmelweis Medical School between January 1., 1990 and December 31., 1995. The frequency of caesarean section in this group was 75.5%. In the subgroup of very small neonates (those under the birthweight of 1500 grams) caesarean section was performed in 71.4%. In this group 73.8% of the neonates were alive on the 28th postpartum day, as opposed to 37.7% in the group spontaneously delivered. The difference proved to be significant in the group weighing between 750 and 1249 grams. Intraventricular haemorrhage was also more frequent in the group spontaneously delivered. The difference was not significant in the groups under 750 grams and between 1250 and 1500 grams birthweight. Based on their investigation the authors conclude, that in the group of fetuses whose estimated birthweight is predicted to be between 750 and 1250 grams by ultrasound examination, perinatal mortality and morbidity rates in breech presentation can be improved by performing caesarean section.

Breech Presentation↗
PubMed1995

[Correlation between neonatal mortality and hyperinsulinema].

The authors investigated the correlation among the severity of maternal diabetes, the tight control of the maternal blood glucose concentration and the neonatal morbidity. Umbilical cord insulin level were measured in 115 newborns, 40 of them have diabetic mother. There were significant different in the serum insulin level between the low and high morbidity group. The authors suggest the importance of the tight blood glucose control during pregnancy, the diagnostic value of cardiological ultrasound to decrease the neonatal morbidity.

Congenital Abnormalities↗
PubMed1995

[Insulin concentration in amniotic fluid in mid-term pregnancy].

Insulin concentrations of 284 amniotic fluid samples were assessed, obtained from pregnant women by genetic amniocentesis between the 16-18 gestational weeks. The indication of amniocentesis was either advanced maternal age (> 35 years) or high risk genetic history. The amniotic fluid insulin concentration (mean +/- SD) was found 3.8 +/- 3.0 microIU/ml. The insulin concentration in 4.3% of all pregnant women was higher than the mean value +2 SD (9.8 microIU/ml) which represents individual pathological value, characteristic for gestational diabetes. Our data suggest that one part of gestational diabetes might be detected between the 16-18 gestational weeks, therefore we propose an earlier screening as the usual one. At institutes where the possibility of genetic amniocentesis is given the determination of insulin level in amniotic fluid may be reasonable. We could analyze the outcome of 230 pregnancies analysed. A close correlation was found between the amniotic fluid insulin concentration and birthweights of female newborns. It could not found such correlation at male newborn. A more careful screening test for gestational diabetes should be performed at mothers with female fetuses.

Amniocentesis↗
PubMed1992

[A successfully treated case of congenital hydrops by Kell-alloimmunization].

The authors report a successfully treated case of congenital hydrops caused by Kell alloimmunization. It is very important the early proper therapy and to make difference between the non immune hydrops fetus and the hydrops caused by alloimmunization. It seems to be indicated--also in Hungary, as the other European countries--the introduction of the screening of irregular antibodies during the pregnancy.

Adult↗
PubMed1992

Congenital osteogenesis imperfecta associated with arteriopathia calcificans infantum.

A 25-year-old mother during pregnancy was treated by accident with clomifen (Clostilbegyt). Ultrasound scan, performed in the 32nd gestational week, showed polyhydramnion and abnormally short, deformed fetal limbs. The newborn male infant died 20 minutes after caesarean section. Autopsy revealed osteogenesis imperfecta accompanied by a rare vascular alteration i.e. arteriopathia calcificans infantum. The possible relationship between the two diseases and estrogen therapy is discussed.

Arteries↗
PubMedDate not supplied

Very-low-birthweight breech infants: short-term outcome by method of delivery.

The purpose of this study was to determine the incidence of mortality and morbidity of the very-low-birthweight infant (< 1,500 g) in breech presentation based on mode of delivery and birthweight. A retrospective chart review of 1,009 infants who were in breech presentation at the time of delivery between January 1, 1990 and December 31, 1995 at the First Department of Obstetrics and Gynecology of Semmelweis Medical School in Budapest, Hungary. Data collected included birthweight, mode of delivery, pregnancy complications and neonatal mortality and morbidity. Comparison of groups was made based on mode of delivery, and data were analyzed using Fisher's exact test and chi-square analysis. For those infants weighing less than 1,500 g at birth, vaginal delivery was associated with higher mortality than for those delivered abdominally (73.8% vs. 37.7%, P < 0.001). There was no significant difference in survival for those infants weighing 1,500 g or more. Regarding morbidity, in those infants weighing less than 1,500 g, vaginal delivery was associated with a higher incidence of 1 min Apgar below 4 (21.7% vs. 5.2%, P < 0.001), a higher incidence of 5-min Apgar scores below 4 (11.6% vs. 1.2%, P < 0.001), a higher incidence of grade III or grade IV IVH (18.8% vs. 3.5%, P < 0.001) and a higher incidence of necrotizing enterocolitis (5.8% vs. 0.6%, P < 0.05). There is an increased incidence of mortality and morbidity for the VLBW breech infant delivered vaginally. Cesarean delivery may improve outcome for these infants.

Breech Presentation↗
PubMedDate not supplied

["Maternal floor infarct", simultaneous manifestation of intrauterine fetal retardation and high maternal AFP level].

High AFP level (386.9 ng/ml) at the 16th gestational week in a 23-year old pregnant woman was observed. Fetal malformations or maternal causes could not be detected. Monitoring of fetal development and that of the fetal heart rate showed a worsening intrauterine growth retardation (IUGR). Due to the chronic hypoxia and IUGR cesarean section was performed in the 32nd gestational week and a 960 g female newborn was delivered. Histological examination of the placenta showed signs of maternal floor infarct (MFI): intervillous fibrin netlike deposition with the increase of extravillous trophoblast (X cells) and septal cystic formation. High unexplained AFP level and IUGR can draw attention to the possibility of intrauterine fetal demise, which indicates intensive intrauterine fetal monitoring.

Adult↗