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Biomedical subjects

E P Schneider

Publications and source records attributed to E P Schneider.

13 recordsLinked to original sources
PubMed2000

Effect of antenatal steroid administration on the fetal biophysical profile.

PURPOSE: Our objective was to determine whether antenatal steroid administration affects the biophysical profile score in fetuses. METHODS: A prospective study was conducted in 84 fetuses between 28 and 34 weeks' menstrual age at risk of preterm delivery. Two intramuscular injections of 12 mg of betamethasone were given to the mother 24 hours apart. All fetuses underwent biophysical profile testing prior to and between 24 and 48 hours after steroid administration. Biophysical profiles (including nonstress tests) were evaluated by two maternal-fetal medicine specialists blinded to the timing of steroid administration. Neonatal outcome, including Apgar score, menstrual age at delivery, admission to and length of stay in the neonatal intensive care unit, and mortality, was analyzed in all subjects. RESULTS: In 31 (37%; 95 confidence interval, 26.6-47.2%) of 84 cases, the biophysical profile score decreased at least 2 points after steroid administration. The most commonly affected variables were fetal breathing and the nonstress test. There was no significant difference in the neonatal outcome between the fetuses whose biophysical profile decreased and those whose did not. CONCLUSIONS: Biophysical profile scores were decreased in more than one third of fetuses within 48 hours of antenatal steroid administration, but neonatal outcome was not affected. Knowledge of this occurrence could avoid incorrect decision making regarding fetal well-being.

Adult↗
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↗
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↗
PubMed1995

Isolated fetal hydronephrosis: beware the effect of bladder filling.

The aim was to assess the role that fetal bladder size has in the determination of fetal hydronephrosis. Forty-three fetuses were evaluated for fetal hydronephrosis in the second trimester of pregnancy. Anteroposterior measurements of the renal pelvis were obtained with a full bladder and again when the bladder emptied in each fetus. Statistical analysis was performed using the Spearman rank order correlation coefficient to assess the relationship between bladder status and renal dilation. The anteroposterior size of the fetal renal pelvis diminished from 6.8 +/- 1.8 mm on a full bladder scan to 4.5 +/- 1.6 mm when the bladder was emptied (P < 0.001). Fifty-three per cent of the fetuses whose renal pelvic measurements were 5 mm or more on a full bladder scan had normal-appearing renal pelvises when their bladders emptied. The status of the fetal bladder should be considered when evaluating fetal hydronephrosis.

Diagnostic Errors↗
PubMed1988

An assessment of the first decade's experience with antepartum fetal heart rate testing.

The utility of antepartum fetal heart rate (APFHR) monitoring (nonstress test and the contraction stress test) was evaluated for a 10-year interval from 1974 through 1983. The number of high-risk patients evaluated increased from 2.9 to 25.1% of all deliveries. The decade's perinatal mortality rate differed from 22.4 per 1000 in the nontested population to 11.8 per 1000 in the tested population; the stillbirth rate differed from 11.1 per 1000 to 5.4 per 1000 uncorrected, 2.2 per 1000 corrected, and perinatal morbidity also differed from 26.1 per 1000 to 24.9 per 1000 (NS). Improvement statistics appear to plateau by the fourth year. An abnormal APFHR test was associated with a lethal congenital anomaly in 2.54% of patients (versus 0.5 to 1.5% in the general population). Evaluation for the presence of congenital anomalies appears to be indicated in the fetus with an abnormal APFHR test. A lower stillbirth rate occurred within 4 days of a normal APFHR test (0.027%) compared with a test interval of 5 to 7 days (0.11%). Thus, APFHR testing performed twice weekly may offer a better outcome for the fetus at risk than once weekly testing. This report confirms that the chief value of APFHR testing is its ability to identify the normal healthy fetus. These tests are somewhat less accurate at identification of the sick fetus. The nonstress test and contraction stress test were found to be of similar clinical predictive value.

Apgar Score↗
PubMed1988

Detection of cardiac events by continuous electrocardiogram monitoring during ritodrine infusion.

Cardiac events in 30 patients in preterm labor on ritodrine therapy were examined continuously on a Holter monitor. Unsuspected events, such as persistent severe tachycardia, premature ventricular contractions, and supraventricular premature contractions, were observed. These events did not occur more frequently in patients with cardiac symptoms. None of these changes were observed by standard monitoring methods. Continued beta-mimetic stimulation in the presence of these events may lead to the serious cardiopulmonary complications that have been reported during ritodrine infusion.

Angina Pectoris↗
PubMedDate not supplied

Fetal breasts in normal and Down syndrome fetuses.

UNLABELLED: To assess the validity of fetal breast size measurement as a sonographic marker in fetuses with Down syndrome. METHODS: Fetal breasts were studied in 26 fetuses with trisomy 21 and 78 fetuses with normal chromosomes. Breasts were identified and measured in a cross-sectional plane of the fetal chest at the level of the four-chamber view of the heart. Normal fetuses had a mean breast size of 3.8 mm +/- 1.1 mm. Fetuses with Down syndrome had a mean breast size of 1.9 mm +/- 0.7 mm (p < or = 0.0001). Diminished breast size measured by ultrasound in the second trimester may be helpful in identifying fetuses with Down syndrome.

Breast↗
PubMedDate not supplied

Clinical significance of echogenic foci in fetal lungs.

PURPOSE: We reviewed our experience with echogenic foci in fetal lungs. METHODS: During the period January 1991 through December 1995, 16,292 patients underwent comprehensive ultrasound examinations between 16 and 42 weeks of pregnancy. Echogenic foci in the lungs were identified in 8 fetuses. All 8 underwent karyotyping, fetal echocardiography, screening for infectious agents, and follow-up sonography. The neonatal outcome was obtained in each case. RESULTS: The 5 fetuses in whom echogenic foci in the lungs were the only abnormal finding all had normal outcomes. One fetus had echogenic foci identified in 1 lung and the abdomen. This fetus tested positive for cytomegalovirus, and the pregnancy was terminated. Two fetuses with echogenic foci in the lungs had associated anomalies: 1 had an omphalocele, and the other had cerebral ventriculomegaly. Both of these pregnancies were terminated. CONCLUSIONS: In our series, isolated echogenic pulmonary foci were rare findings that carried a good prognosis. When echogenic foci in the lungs are identified, careful evaluation for associated abnormalities is warranted.

Female↗
PubMedDate not supplied

Cordocentesis using the combined technique; needle guide-assisted and free-hand.

Two hundred and sixteen diagnostic cordocenteses were performed using the following technique: A guide was used to deliver the distal end of the needle to the immediate vicinity of the umbilical cord, after which the needle was released from the guide and a free-hand technique was used to enter the umbilical cord. The vessel punctured was identified by its sonographic appearance and flow direction using color Doppler technology. All procedure-related losses which occurred within 2 weeks were analyzed. The gestational age at the time of cordocentesis ranged from 18 to 42 weeks. Most punctures (62%) were performed at the placental insertion of the umbilical cord. In 32% of fetuses the free-floating loop was sampled and in 6% the puncture was performed at the site of cord entry into the fetus. Two fetuses died shortly after cordocentesis. One death occurred at 28 weeks in a fetus with severe cytomegalovirus infection. The other death was due to premature rupture of the membranes after the procedure in a very premature fetus. The overall fetal loss rate was 0.93%. In conclusion, the combination of the two cordocentesis techniques appears safe and highly successful in obtaining fetal blood samples.

Cordocentesis↗