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Biomedical subjects

E Sadovsky

Publications and source records attributed to E Sadovsky.

At least 37 records · Page 2Linked to original sources
PubMed1988

Antepartum fetal heart rate characteristics in cases of premature rupture of membranes.

The present retrospective study investigates the effect of premature rupture of membranes on fetal neurocardiac maturation as reflected by the fetal heart rate (FHR) pattern. The FHR tracings of 41 cases involving premature rupture of membranes of at least 48 hours' duration at 24 to 37 weeks' of gestation were studied. Fifty-two cases of normal pregnancy who were matched for gestational age served as controls. The results demonstrate similar baseline FHR and variability in the study and control group. The incidence of FHR accelerations of 15 beats/min was significantly greater in cases of premature rupture of membranes, and their onset was detected at an earlier gestational age. In addition, the mean amplitude of FHR accelerations was significantly greater in the study group compared with the control group. As a result, patients with premature rupture of membranes have a reactive nonstress test at an earlier gestational age than do control patients. These findings support the concept that premature rupture of membranes causes accelerated neurocardiac fetal maturation, as reflected by FHR pattern, possibly by inducing a stressful intrauterine environment.

Female↗
PubMed1987

Alterations of pathological fetal heart rate patterns in labor following vibroacoustic stimulation.

Vibroacoustic stimulation of the fetus in labor was previously shown to result in a transient fetal heart rate (FHR) tachycardia followed by a return to prestimulation FHR pattern. We presently report 3 cases in which FHR patterns of repeat decelerations were changed to normal following vibroacoustic stimulation. These changes may be related to the strong fetal movements evoked by the stimulation and removal thereby of a mechanical problem such as cord compression.

Adult↗
PubMed1987

Ultrasonographical evaluation of the incidence of simultaneous and independent movements in twin fetuses.

Fetal movements (FM) may be spontaneous, originating in the fetus itself, or evoked by external stimuli. The relative rate of spontaneous and evoked FM has not yet been documented. As it is impossible to differentiate in a singleton pregnancy between these types of movements - the natural model of twin pregnancy was used. The FM of 10 normal twin pregnancies between 33 and 39 weeks of gestation were studied by two realtime ultrasounds, and were operated by two ultrasonographers over a period of 10 min. The mean number of independent FM of each fetus which occurred while the other fetus was resting was 7.9 FM and 7.7 FM, respectively (average 7.8 FM). A mean of 2.5 FM occurred simultaneously. The rate of independent FM was 75.7% and that of simultaneous FM was 24.3%. Vibroacoustic stimulation applied to the maternal abdomen evoked simultaneous movements of both fetuses in all cases. It is suggested that the independent FM may represent spontaneous FM and that the simultaneous FM may indicate the presence of an external stimuli and are therefore evoked responses.

Female↗
PubMed1986

Fetal activity in pregnancies complicated by systemic lupus erythematosus.

Fetal movements were assessed in 7 cases of systemic lupus erythematosus (SLE). The daily fetal movement count was lower than normal in 4 cases. Three patients with renal disease and raised blood pressure had decreased fetal movements until cessation and poor fetal outcome. Uncomplicated cases of SLE did not manifest cessation of fetal movement, and their fetal outcome was favorable. When a decrease in fetal movements becomes apparent and the condition is verified by other biophysical tests, the patient should be delivered provided the fetus is viable.

Female↗
PubMed1986

Fetal response to vibratory acoustic stimulation in periods of low heart rate reactivity and low activity.

The fetal response to vibratory acoustic stimulation during periods of low fetal activity and low fetal heart rate reactivity was studied in 10 healthy pregnant women at term. In each case, two periods of low reactivity were studied. Consecutive cases alternated: The vibratory acoustic stimulus was applied 10 minutes after the first nonreactive period in half of the cases; the remainder were stimulated during the second nonreactive period. The unstimulated period served as a control. After vibratory acoustic stimulation the baseline fetal heart rate, the mean number of fetal heart rate accelerations, and, the number of fetal movements were significantly increased with values in the control nonstimulated periods (p less than 0.0001). This consistent response to vibratory acoustic stimulation may prove to be clinically useful in altering periods of low reactivity observed during nonstress testing of normal fetuses.

Acoustic Stimulation↗
PubMed1986

Fetal activity in premature rupture of membranes.

Fetal movement (FM) counts by mothers with premature rupture of membranes (PROM) may be helpful in estimating fetal well being, provided FM assessment is not altered by the reduced amniotic fluid. It is possible that the decreased uterine volume restricts fetal movements, though the closer contact of the fetus to the uterine wall may enhance maternal perception of even weak FM. The present study compared maternally perceived FM in 41 cases of PROM to 120 uncomplicated pregnancies. No significant differences in FM counts were detected between the two groups at any of the gestational ages. Fetal movement counts by mothers with PROM, therefore, can assist fetal surveillance as is the case in pregnancies with intact membranes.

Female↗
PubMed1986

An unusual case of rhesus isoimmunization.

A case of rhesus isoimmunization with spontaneous improvement in severity of erythroblastosis with advancing parity is presented. The isoimmunized pregnant woman after having 3 perinatal deaths all due to severe hydrops fetalis, subsequently delivered 2 Rh-positive surviving infants. In her last pregnancy, the timing of delivery was indicated by cessation of fetal movements, followed by a sinusoidal fetal heart rate pattern. The newborn, needing 5 exchanging blood transfusions, subsequently did well.

Adult↗
PubMed1986

Intrapartum vibroacoustic stimulation in cases of normal and abnormal fetal heart rate patterns.

The fetal heart rate (FHR) response to a vibroacoustic stimulation was studied in 100 women during active labor. Three types of FHR responses were noted: acceleration, tachycardia of duration longer than 2 min, and combined acceleration-deceleration response. The last type was significantly more common in labors with abnormal FHR tracings. All fetuses demonstrating FHR response to the stimulation, including those with abnormal FHR tracings, had good outcome. The vibroacoustic stimulation is easily performed, noninvasive, and has no contraindications. Its possible application as an intrapartum test of fetal well-being awaits further clinical confirmation.

Acoustic Stimulation↗
PubMed1986

Incidence of spontaneous and evoked fetal movements.

Fetal activity is composed of fetal movements (FM), which are either nonreflexive, originating in the fetus itself, or evoked reflexive FM which are stimulated by the fetal environment. The relative ratio of the spontaneous to evoked FM has not yet been documented. Since it is impossible to differentiate in a singleton pregnancy between these two types of FM on the basis of maternal perception alone, the natural model of twin pregnancy was used. It has previously been shown that the number of FM in a singleton pregnancy is similar to that of each individual fetus in a twin pregnancy of the same gestational age. It was assumed that the factors which cause spontaneous and evoked FM are similar in singleton and twin pregnancies. The fetal activity in 44 twin and 76 singleton pregnancies between 28 and 39 weeks of gestation was assessed during 20 min of nonstress test recording. The means of FM in twins were significantly higher than those in singleton pregnancies. The rate of the spontaneous FM was calculated to be 50-59% of all FM in singleton pregnancies and that of the evoked FM 41-50%.

Female↗
PubMed1986

Fetal activity in pregnancies complicated by rheumatic heart disease.

Severe cardiac disease in pregnancy may be complicated by reduced placental perfusion and subsequent fetal deprivation. In the present study we have evaluated one fetal parameter that may thus be affected, namely fetal activity. The study group included patients with rheumatic heart disease: 36 women with mild and 5 with severe disease. Each counted fetal movements 3 times a day and from this the daily fetal movement recording was calculated. One hundred and twenty women with normal pregnancies were the controls. The mild cases had fetal activity which was similar to that of the controls. The severe cases had reduced fetal activity, which was significant statistically at 29 to 32 weeks of gestation. Three in the severe disease group had marked decrease of fetal movements on admission to hospital. A return to normal fetal activity was observed following improvement of the maternal cardiac state. As was previously suggested for other high and low risk pregnancies, the maternal perception and counting of fetal movements may aid the fetal surveillance of patients with rheumatic heart disease.

Female↗
PubMed1985

Fetal heart rate accelerations and fetal movements in twin pregnancies.

The rate of fetal heart rate accelerations associated with fetal movements to total fetal movements of twin pregnancies was found to be significantly lower than that of pregnancies with singleton infants. The number of fetal heart rate accelerations was similar. As fetal heart rate accelerations are reflective of fetal movements, the results indicate increased fetal activity in twins that is related to an additive effect of two normally active fetuses.

Female↗
PubMed1985

Fetal movements in hypertensive pregnancies.

The maternally perceived fetal movements counts of 273 hypertensive patients were compared to normal controls and their degree of fetal activity was related to perinatal outcome. Pregnancy induced hypertension was associated with fetal activity which was significantly lower than controls at the beginning of the third trimester and significantly higher at term. In cases of chronic hypertension patients, 8 had cessation or marked reduction of fetal movements to less than 4 in 12 hours, and all had poor fetal outcome. The remaining 265 hypertensive patients had a 92% incidence of good fetal outcome. Markedly reduced fetal movements in hypertensive patients are highly suggestive of fetal distress and following verification by additional tests the appropriate clinical measures should be undertaken.

Female↗
PubMed1985

Nonimmunologic hydrops fetalis: a review of 11 cases.

Eleven cases of nonimmunologic hydrops fetalis occurring during a six year period were reviewed. The etiology of hydrops fetalis was established only in four cases. It included one case of endocardial fibrosis, two cases of non-immunologic hemolysis and one case of tachycardia. The pregnancies were complicated by polyhydramnios in 9 cases, preterm delivery in 10 cases, twins in 3 cases and pre-eclampsia in one case. Four of 11 fetuses died in utero, on one of them, intrauterine blood transfusion and administration of digoxin and furosemide was carried out. Five fetuses died neonatally and two survived. In one of the later cases, intravenous administration of digoxin with quinidine to the mother was without effect, nor did such treatment cause any effect on the neonate after delivery. Electric cardioversion supplemented with digoxin slowed the neonatal cardiac rhythm to normal range with later successful outcome. Earlier diagnosis by ultrasonography especially in cases of hydramnios and appropriate treatment are likely to improve this outcome.

Adult↗
PubMed1984

The relationship between fetal heart rate accelerations, fetal movements, and uterine contractions.

The association between fetal heart rate (FHR) accelerations and fetal movements during uterine contractions was studied in 52 pregnant women near term or at the beginning of labor. FHR and uterine contractions were recorded by tococardiograph. At the same time, fetal movements, whether associated or not with contractions, were viewed by real-time ultrasound. During uterine contractions, 95.5% of the FHR accelerations were associated with fetal movements. Also, 90.9% of the accelerations which appeared when the uterus was not contracting were associated with fetal movements. Fetal movements were not seen in 91% of uterine contractions which were not associated with FHR accelerations. The suggestion is made that uterine contractions stimulate both fetal movements and FHR accelerations.

Female↗