Biomedical subjects
Publications and source records attributed to E Paldi.
The Porges technique for vaginal hysterectomy is described and a series of 100 cases is presented. The ease and advantages of the technique, such as fewer operative stages, shortened operating time, low morbidity and short hospitalization are emphasized. There were no complications related to the operative technique, either during or after the operation.
Fifty obstetric patients with asymptomatic bacteriuria were treated by single-dose antimicrobial therapy. The immediate cure rate was 84% and the recurrence rate was 12%. Seven of the eight patients in whom single-dose treatment failed responded to subsequent 7-day therapy with the same drug, indicating renal involvement. A 50% recurrence rate in the group of patients in whom single-dose treatment failed was compared with a 5% recurrence rate in the group cured by single-dose therapy, which indicates that failure with single-dose antimicrobial therapy can serve as a therapeutic test to identify patients at high risk for recurrent bacteriuria and its sequelae during pregnancy. It is concluded that single-dose antimicrobial therapy is a safe and effective way to treat asymptomatic bacteriuria in pregnant patients without urologic problems in their history.
Many studies concerning the various aspects of cesarean section have recently appeared in the literature. The important issues are the changing indications for the operation and the different management protocols in trial of labor following a previous cesarean section. As the different authors use different ways of presenting their results, comparison of these studies is a complex matter and the conclusions are sometimes misleading. It is proposed that the data presented should be more uniformly used, according to the principles presented in this study.
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This study explores the relationship between fetal heart rate variability and fetal breathing movements in the term fetus. Fourier analysis was applied to fetal heart rate variability during fetal breathing and nonbreathing episodes. A distinct component in the order of 0.7 to 0.95 Hz was demonstrated in fetal heart rate variability during breathing episodes. These frequencies have the same distribution as the corresponding rate of breathing and therefore indicate that respiratory sinus arrhythmia exists in the term fetus.
A computerized quantification of fetal heart rate and beat-to-beat variability was performed during and between fetal breathing episodes. Sixteen healthy pregnant women at term participated in the study. The results indicate that fetal breathing is associated with a significant increase in beat-to-beat variability (from 4.48 +/- 1.66 between breathing episodes to 5.80 +/- 2.04 during breathing episodes, p less than 0.01) and a small but significant decrease in fetal heart rate (from 142.7 +/- 8.6 bpm between breathing episodes to 140.4 +/- 8.6 bpm during breathing episodes, p less than 0.05).
The Grand Multipara (GM) has almost disappeared in the Western countries due to the advancement of family planning. Having a heterogeneous population, the problem of Grand Multiparity still exists in our country. This study is based on 5785 cases of GM which were treated in our Obstetrical Department during a period of 16 years (1960-1975). We have compared this group to the general obstetrical population in terms of pregnancy and delivery complications. Face and breech presentations as well as transverse lie were twice, brow presentations were three times as frequent in the GM group. Postpartum hemorrhage (P.P.H.) was four times and premature separation of the placenta twice as frequent. Rupture of the uterus was about 20 times more frequent. Forceps delivery and Cesarean section rate were twice, while the vacuum extraction 5-fold more frequent. Though there was no material mortality and perinatal mortality was not higher than in the general population. Even though the percentage of GM in our population has been decreased in the last 10 years, our results suggest that Grand Multiparity is still a high risk obstetrical problem.
This study was undertaken to evaluate the effect of maternal intravenous (IV) administration of glucose on fetal breathing and its associated fetal heart patterns. Sixteen healthy women at term gestation participated in the study. The outcome of each of the pregnancies was normal. Fetal breathing and fetal electrocardiograms were simultaneously recorded by real time sonography and a fetal monitor respectively, and then digitized into a microcomputer. These women were studied for a 25-minute control period, given 50 gm of glucose IV and then, 20 minutes later, restudied for an additional 25-minute period. The results indicate that fetal breathing movements lasted for 24.8 +/- 6.2 percent of the time during the control period (mean +/- SEM) and were increased to 63.2 +/- 11.5 percent following the injection of glucose (P less than 0.01). Fetal heart rate decreased during fetal breathing by 2.3 and 2.1 beats per minute, before and after glucose administration, respectively (NS). Fetal breathing was associated with increased beat-to-beat variability by 1.32 +/- 0.5 and 1.27 +/- 0.3, before and after glucose administration, respectively (NS). This study confirms previous reports that the amount of time the fetus spends making breathing movements is significantly increased following maternal glucose administration, and demonstrates that the injection of glucose does not alter the modulation of fetal heart rate and beat-to-beat variability by fetal breathing.
Fetal body movements and breathing movements were recorded with a real time ultrasound scanner in 26 fetuses. There were two recording periods of 25 min each, before and half and hour after maternal IV administration of 50 gr glucose. Six fetuses were at 280 days of gestation (Group A), twelve fetuses were at 294 days of gestation (group B), eight fetuses at 294 days gestation were classified as stage I postmature (group C). The incidence of fetal body movements was not significantly different in the three groups. Maternal glucose administration had no significant influence on fetal body movements in any group. On the other hand fetal breathing activity was significantly increased in all three groups after maternal glucose administration. Breathing activity was significantly greater in group A when compared to group C in both recording periods, and when compared to group B in the period which followed maternal glucose administration. It is concluded that fetal breathing activity is reduced in prolonged pregnancies.
Severe cyclic dysmenorrhoea in a young woman with a unilateral abdominopelvic mass terminating in a purpuric bulge in the lateral vaginal wall, and resulting in renal agenesis ipsilateral to the pelvic mass, suggests uterus didelphys with unilaterally imperforate vagina. A report of two cases, their diagnostic and therapeutic approach and review of the literature are presented.
A computerized system was used during labor to provide a quantitative and objective analysis of fetal heart rate, beat-to-beat variability, and uterine contractions. Twenty-nine healthy pregnant women at term participated in this study. Each woman was studied for a 40-minute period during the active phase of spontaneous labor. The results indicate that beat-to-beat variability rises from a value of 4.62 +/- 1.11 (mean +/- SD) between contractions to 6.86 +/- 1.53 during contractions. This rise is significant (p less than 0.01). At the same time, changes in fetal heart rate are small, inconsistent, and not significant. We conclude that an increased beat-to-beat variability is commonly associated with uterine contractions in normal fetuses. This increase is probably due to mild hypoxia caused by decreased perfusion of the placenta and to increased vagal tone caused by fetal head compression.
An inexpensive microcomputer has been devised to analyze fetal heart signals and fetal activity which were simultaneously recorded. Digital techniques were used to provide quantitative analysis of each of these inputs, and the interrelations among them. A parallel graphical presentation of those inputs was also provided.
Five fetuses with cystic hyroma were diagnosed in our department during a period of 5 months. Four of them were identified by an ultrasonic examination. No common causative factor was found to explain the appearance of such a rare anomaly in 5 cases over a very short period of time.
In 52 cases of breech presentation, the biparietal diameter of the fetal head was measured before and after external version of the fetus. There was no significant statistical difference between these two measurements.
Ovarian hyperstimulation syndrome was induced in rabbit by administration of human menopausal gonadotropin (HMG) and human chorionic gonadotropin (HCG). In an attempt to establish whether serotonin plays a part in the induction of this syndrome, the hyperstimulated rabbits were divided into two groups and were administered known anti-serotonin drugs, cyproheptadine and methysergide, respectively. The group treated with cyproheptadine, a non-specific serotonin antagonist, exhibited significant acceleration in the regression of the syndrome. Methysergide, a specific serotonin antagonist, administered to the second group, neither prevented the occurrence of the syndrome nor accelerated its regression. The results of this work indicate that serotonin does not seem to be directly involved in the production of the ovarian hyperstimulation syndrome in rabbits.
The effect of the maternal postural position on the Nonstress Test (NST) was evaluated in 14 normal pregnancies at 38-40 weeks of gestation. Each women was studied for two periods of 30 min, each in the standing and left lateral recumbent positions. Comparing both positions no significant difference was found in the number of fetal movements and heart rate accelerations. The total surface area of accelerations (TSAA) was significantly larger in the standing position.