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Biomedical subjects

G Pilu

Publications and source records attributed to G Pilu.

At least 73 records · Page 4Linked to original sources
PubMed1989

Sonographic evaluation of the normal developmental anatomy of the fetal cerebral ventricles: II. The atria.

A prospective ultrasound study was conducted on 171 normal pregnancies ranging in gestational age from 15 weeks to term to evaluate the developmental anatomy of the atria of the lateral ventricles. The atrial width showed no significant modifications throughout gestation, remaining fairly constant. Significant linear relationships were found between the cerebroatrial distance and gestational age (R2 = 0.88; P less than .0001) and between the cerebroatrial distance and the biparietal diameter (R2 = 0.936; P less than .0001), with a first- and second-order regression equation being the best fit, respectively. From these data, growth of the atria was characterized both biologically and mathematically, providing a comprehensive evaluation of the atrioventricular system throughout pregnancy. Such data offer the potential for early prenatal diagnosis of various types of developmental abnormalities of the fetal ventricular system.

Cerebral Ventricles↗
PubMed1988

Subnormal cerebellum in fetuses with spina bifida.

The results of a prospective ultrasound study of the posterior fossa structures in 19 fetuses with spina bifida are reported. The transverse cerebellar diameter is below the normal limits and the cisterna magna is obliterated in all cases. Decreased cerebellar size and failure to visualize the cerebellum appear to be specific findings for spina bifida since they are not present in a group of 17 fetuses with isolated hydrocephalus. The results of this study indicate that ultrasound investigation of the posterior fossa may prove useful in the prenatal diagnosis of spina bifida.

Arnold-Chiari Malformation↗
PubMed1988

Sonographic diagnosis of agenesis of the corpus callosum in the fetus and newborn infant.

The sonographic findings in nine cases of agenesis of the corpus callosum examined before and after birth are reported. Agenesis of the corpus callosum was suspected in utero due to a typical configuration of the lateral ventricles, which included enlargement of the atria and occipital horns and marked separation of the bodies. In three cases pregnancy was terminated because of severe associated anomalies. In the remaining six cases postnatal ultrasound examination allowed a certain diagnosis by demonstrating the abnormal configuration of the lateral ventricles, varying degrees of enlargement, and upward displacement of the third ventricle and absence of the corpus callosum.

Agenesis of Corpus Callosum↗
PubMed1988

Intravascular intrauterine transfusion for severe erythroblastosis fetalis using different techniques.

Over a 3-year period, 44 ultrasound-guided intravascular transfusions were performed between 18 and 32 weeks on 15 patients with severe erythroblastosis fetalis due to Rh immunization. In 4 fetuses, the first transfusion was performed before 20 weeks, in 6 between 20 and 25 weeks and in the remaining 5 between 25 and 31 weeks. Eight of the 15 fetuses were hydropic at the time of referral. Five transfusions were done in the intrahepatic umbilical vein, 6 were simple transfusions via percutaneous umbilical cord puncture, and 33 were partial exchange. There were 4 intrauterine deaths before 26 weeks, despite successfully performed transfusions: 3 of these fetuses were severely hydropic, while in the remaining fetus hydrops had been reversed in utero. Following delivery by cesarean section at 32 weeks of gestation, 1 of the neonates developed respiratory distress syndrome and died 17 h after birth. The overall survival rate was 67% (10 of 15 cases): 4 of the 8 hydropic fetuses (50%) and 6 of the 7 nonhydropic fetuses (83%) were alive at birth and survived the perinatal period. Three of the 5 losses occurred among the first 4 cases, while in the last 11 cases the survival rate increased to 82% (9 of 11).

Blood Transfusion, Intrauterine↗
PubMed1988

Sonographic assessment of the fetal frontal lobe: a potential tool for prenatal diagnosis of microcephaly.

A prospective ultrasound evaluation of 150 normal pregnant women was conducted between 15 and 40 weeks' gestation. A variety of biometric measurements were obtained that included measurements of the frontal lobe distance (the anterior edge of the frontal horns of the lateral ventricles to the frontal bone) and the thalamic frontal lobe distance (measured from the posterior edge of the thalami to the frontal bone). Analysis of these data revealed a high degree of correlation between the gestational age and the frontal lobe distance (R2 = 0.89, p less than 0.0001), and between the gestational age and thalamic frontal lobe distance (R2 = 0.93, p less than 0.0001). Similarly, a high degree of correlation was also found between the biparietal diameter and the frontal lobe distance (R2 = 0.95; p less than 0.0001), between the biparietal diameter and the thalamic frontal lobe distance (R2 = 0.90, p less than 0.0001), and between the frontal lobe distance and the thalamic frontal lobe distance (R2 = 0.92, p less than 0.0001). The relationships between femur length and frontal lobe distance (R2 = 0.89, p less than 0.0001) and between the femur length and the thalamic frontal lobe distance (R2 = 0.945, p less than 0.0001) were also evaluated. Nomograms for the relationships between gestational age and frontal lobe distance and thalamic frontal lobe distance were generated and included the mean +/- SD and the percentile distributions. Growth of the frontal lobe was best described by a first-degree linear equation. The results of this study demonstrate the pattern of growth of the frontal lobe and the high rate of correlation between growth of the frontal lobe and the gestational age and the biparietal diameter. These findings offer a potential method by which the decreasing size of the frontal lobe, as shown in three cases described herein, can be evaluated prenatally and thus serve as a useful tool in the prenatal diagnosis of microcephaly.

Female↗
PubMed1987

Prenatal diagnosis and obstetrical management of multicystic dysplastic kidney disease.

Multicystic dysplastic kidney disease (MDKD) is one of the most common congenital renal anomalies. We report 16 consecutive cases of MDKD recognized in the antenatal period by sonography. Diagnosis is usually easy as MDKD has in the vast majority of cases a striking ultrasound appearance including enlargement of the kidney and multiple renal cysts. However, differentiation from obstructive uropathy may be difficult, and we made a total of five erroneous diagnoses. Unilateral MDKD has almost invariably a good prognosis. However, severe life-threatening associated anomalies were found in six cases. Therefore, a detailed survey of fetal anatomy and determination of karyotype are strongly recommended.

Diagnostic Errors↗
PubMed1987

Cerebellar measurements with ultrasonography in the evaluation of fetal growth and development.

A prospective study of ultrasonography was conducted in 371 normal pregnant women, with gestational ages ranging from 13 weeks to 40 weeks. Several biometric measurements were obtained including the transverse cerebellar diameter, the biparietal diameter, the occipitofrontal diameter, and the calculated head circumference. Curvilinear relationships were found between the transverse diameter of the cerebellum (measured in millimeters), and the gestational age (R2 = 0.948; P = 0.001), the biparietal diameter (R2 = 0.956; P = 0.0001), and the head circumference (R2 = 0.969; P = 0.0001). A nomogram of cerebellar measurements estimating gestational age and predicting the biparietal diameter and head circumference was generated. Throughout pregnancy the establishment of normative cerebellar measurements allows for the estimation of gestational age that is independent of the shape of the fetal head and offers potential for evaluation of abnormal fetal growth and anomalous development of the central nervous system.

Anthropometry↗
PubMed1987

Fetal cerebellar growth unaffected by intrauterine growth retardation: a new parameter for prenatal diagnosis.

Nineteen pregnant women with a clinical suspicion of intrauterine growth retardation and with gestational age confirmed by early ultrasound examination were referred to our departments for sonographic evaluations. Multiple biometric parameters were obtained, including the transverse cerebellar diameter by use of the electronic calipers of the machine. A prenatal diagnosis of intrauterine growth retardation was made in all cases based on: (1) the transverse cerebellar diameter being consistently correlated with gestational age as predicted by the last menstrual period, whereas most of the other measurements were consistently discrepant with the transverse cerebellar diameter by more than 2.5 weeks (i.e., more than 2 SD above the mean), and (2) the estimated fetal weight of all fetuses being equal to or less than the tenth percentile for gestational age. Neonatal examination confirmed all fetuses to be growth retarded with birth weights at or below the tenth percentile for gestational age. These findings indicate that growth of the transverse cerebellar diameter is unaffected by intrauterine growth retardation; thus this sonographic measurement may serve as an independent and reliable correlate of gestational age against which potential deviations of growth may be compared.

Cerebellum↗
PubMed1987

Fetal echocardiographic screening for congenital heart disease: the importance of the four-chamber view.

The four-chamber view of the heart has been proposed as a screening method for obstetrical sonographers to assess the fetus for the presence of congenital heart disease. We examined the fetuses in 1022 pregnancies and found 74 structurally abnormal hearts. Seventy-one of these (96%) were found to have an abnormality as seen in the four-chamber view. The four-chamber view of the heart had 92% sensitivity and 99.7% specificity in the detection of congenital heart disease. The positive predictive value was 95.8%, and the negative predictive value was 99.4%. We conclude that the four-chamber view may be a useful screen for the presence of congenital heart disease and should be included as a part of all routine obstetric ultrasound examinations.

Echocardiography↗
PubMed1987

Criteria for the prenatal diagnosis of holoprosencephaly.

Holoprosencephaly is a congenital anomaly of the central nervous system whose prenatal sonographic appearance may to similar to that of ventriculomegaly. A clear differential diagnosis is extremely important because the two conditions have different prognoses and therefore require different obstetric management. Eight cases of prenatally recognized holoprosencephaly are analyzed and criteria for a specific diagnosis proposed. The specificity and limitations of ultrasound findings, such as identification of a holoventricle, presence of a dorsal sac, and facial anomalies are discussed.

Brain↗
PubMed1987

Ultrasound investigation of the posterior fossa in the fetus.

One hundred and thirty normal pregnancies, ranging in gestational age from 15 to 40 weeks, were investigated to evaluate the capability of ultrasound to demonstrate the anatomy of the fetal posterior fossa. The cerebellum, including the cerebellar hemispheres, the superior and inferior vermis, the fourth ventricle, and the cisterna magna could be demonstrated easily. The ultrasound interpretation of the brain structures was verified by the anatomic dissection of the brains of 10 stillborn premature infants. A systematic approach to the prenatal ultrasound examination of the posterior fossa is described.

Cranial Fossa, Posterior↗
PubMed1987

Intrinsic intrathoracic malformations of the fetus: sonographic detection and clinical presentation.

Intrinsic intrathoracic malformations are a rare group of congenital anomalies associated with high fetal and neonatal mortality rates. The antenatal sonographic appearance and the adequacy of diagnosis in 15 affected fetuses were evaluated. An accurate prenatal diagnosis was made in 12 cases; the precise nature of the intrathoracic defect was incorrectly categorized in two fetuses, and the defect was missed entirely in one affected fetus. Antenatal detection and characterization of intrinsic intrathoracic congenital malformations seems possible, but requires a high index of suspicion, familiarity with their sonographic appearances, and meticulous attention to detail.

Bronchogenic Cyst↗
PubMed1986

Prenatal diagnosis of craniofacial malformations with ultrasonography.

Although the utility of ultrasound in the prenatal diagnosis of many congenital anomalies is well established, its accuracy in detecting craniofacial malformations has not been examined in a large series. Sonographic examinations of 223 patients at risk for fetuses with craniofacial malformations were performed between 18 and 40 weeks. The risk factors included a familial history of craniofacial malformations, extrafacial anomalies diagnosed on ultrasound, fetal chromosomal aberrations, and maternal drug intake. Sonographic diagnosis was possible in 151 (67.7%) patients on the first scan and in 47 (21.1%) patients on the second scan and was not possible in 25 patients (11.2%). Of the 198 cases diagnosed antenatally, craniofacial malformation was detected in 14 and confirmed postnatally. No false positive diagnoses were made. A negative diagnosis of craniofacial malformation was made in 184 cases with two false negative results (1.0%). Anomalies diagnosed sonographically included anophthalmia, anterior cleft lip and/or palate, hypotelorism, hypertelorism, and micrognathia. The results of this study demonstrate that ultrasound is an accurate and reliable tool for the prenatal diagnosis of craniofacial malformations.

Face↗
PubMed1986

The prenatal diagnosis of Robin anomalad.

The Robin anomalad was diagnosed by the sonographic detection of polyhydramnios and fetal micrognathia in a patient at risk because of a previously affected child. Ultrasound in the second trimester failed to demonstrate any facial anomaly, but mandibular hypoplasia was clearly documented in the third trimester. The antenatal diagnosis allowed immediate neonatal assistance to prevent glossoptosis-induced respiratory failure.

Adult↗
PubMed1986

Congenital heart disease and extracardiac anomalies: associations and indications for fetal echocardiography.

Fetal echocardiography is a well-established technique for the prenatal identification of congenital heart disease. One of the indications for its use is the presence of extracardiac anomalies, as such coexistent defects may have important implications for obstetric and neonatal management. We have reviewed the obstetric and pediatric literature to examine reported associations. If a fetus is suspected to have hydrocephalus, microcephaly, holoprosencephaly, agenesis of the corpus callosum, Meckel-Gruber syndrome, esophageal atresia, duodenal atresia, diaphragmatic hernia, omphalocele, or renal dysplasia, cardiac evaluation should be pursued. Furthermore, echocardiography may be of help in differential diagnosis of some anomalies (for instance, skeletal dysplasias). Maternal diabetes and phenylketonuria, as well as exposure to phenytoin, trimethadione, or isotretinoin, may result in multiple systemic defects, including congenital heart disease.

Abdominal Muscles↗