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Biomedical subjects

G R DeVore

Publications and source records attributed to G R DeVore.

At least 73 records · Page 4Linked to original sources
PubMed1985

The random measurement of the transverse diameter of the fetal heart: a potential source of error.

In a recent report it was suggested that the transverse diameter of the fetal heart measured randomly during the cardiac cycle from the real-time image was useful in predicting congenital heart disease (Jeanty P, Romero R, Cantraine F, et al: Fetal cardiac dimensions: a potential tool for the diagnosis of congenital heart disease. J Ultrasound Med 3:359, 1984). Comparing the above approach with M-mode measurements at end-diastole and end-systole suggests that random measurement of the transverse diameter is not appropriate for fetal cardiovascular evaluation because it could predict over 40 per cent of normal fetuses to have an "abnormally" increased cardiac dimension.

Echocardiography↗
PubMed1984

Fetal echocardiography. IV. M-mode assessment of ventricular size and contractility during the second and third trimesters of pregnancy in the normal fetus.

M-mode echocardiographic examination of the right and left ventricles was performed on 82 normal fetuses between 18 and 41 weeks of gestation. The diameter of the right and left ventricles correlated with the biparietal diameter. The right/left ratio of the ventricular diameters remained constant (1:1) throughout gestation. Fractional shortening and mean circumferential shortening of both ventricles were independent of gestational age. The data presented in this paper will allow the clinician to evaluate abnormal fetal conditions that might affect cardiovascular structure and/or function.

Echocardiography↗
PubMed1983

Fetal echocardiography. III. The diagnosis of cardiac arrhythmias using real-time-directed M-mode ultrasound.

A technique that makes use of real-time-directed M-mode echocardiography is described in which the fetal heart is evaluated for suspected cardiac arrhythmias. Simultaneous M-mode recording of aortic, mitral, or tricuspid valvular leaflet excursion and/or atrioventricular wall motion defines timing relationships between atrial and ventricular systole. With the use of the techniques described in this report, normal as well as abnormal atrioventricular contractions can be quantitated and cardiac arrhythmias accurately defined.

Arrhythmias, Cardiac↗
PubMed1983

Fetal echocardiography. A tool for evaluation of in utero cardiac arrhythmias and monitoring of in utero therapy: analysis of 71 patients.

Fetal echocardiographic studies were performed in 71 patients referred for evaluation of cardiac rhythm disturbances at 24 to 40 weeks' gestation. After 2-dimensional echocardiographic study of cardiac structure was performed, M-mode echocardiograms were analyzed for measurement of cardiac rate, atrioventricular contraction sequence, atrioventricular valve motion, and duration of postectopic pauses. Arrhythmias were diagnosed in 59 patients. In 34 patients with isolated ectopic beats, the arrhythmia resolved during later pregnancy in 26 or within the first 5 days of life in 8. Six patients had mild sinus bradycardia and 8 had frequent sinus pauses; all 14 had resolution of the arrhythmia during pregnancy. Sustained arrhythmias occurred in 11 patients. Deaths occurred when there was associated fetal congestive heart failure (hydrops fetalis), structural heart disease, or both. M-mode echocardiography diagnosed supraventricular tachycardia in 3 fetuses. The echocardiogram was used thereafter for monitoring transplacental digoxin therapy.

Anti-Arrhythmia Agents↗
PubMed1982

Fetal echocardiography. II. The diagnosis and significance of a pericardial effusion in the fetus using real-time--directed M-mode ultrasound.

By means of real-time--directed M-mode ultrasound, the hearts of normal and abnormal fetuses were evaluated for evidence of a pericardial effusion. Because of its limited potential space, the pericardial sac appears to become distended with fluid prior to ultrasound evidence of ascites, pleural effusions, or soft tissue edema. Fetal echocardiography, therefore, appears to be useful in the assessment of fetuses at risk for developing hydrops.

Adult↗
PubMed1982

Fetal echocardiography. I. Normal anatomy as determined by real-time--directed M-mode ultrasound.

With current ultrasound technology, it is now possible to obtain accurate real-time and M-mode information from the fetal heart with the use of real-time--directed M-mode echocardiography. With this method, the M-mode cursor is directed to the fetal cardiac structures of interest while the image is obtained in the real-time mode. This enables M-mode echocardiograms to be obtained in an accurate, reproducible manner. The most useful imaging planes for cardiac evaluation are the long axis four-chamber plane, the short axis plane through the atrioventricular valves, and the short axis plane through the aortic and pulmonic outflow tracts. Once normal fetal cardiac anatomy is understood, structural defects and/or alterations of function can be evaluated accurately antenatally.

Echocardiography↗
PubMed1982

Fetal echocardiography for evaluation of in utero congestive heart failure.

Thirteen fetuses with nonimmune hydrops (22 to 39 weeks of gestation) were evaluated with two-dimensional and M-mode echocardiography. Ten fetuses had cardiovascular abnormalities resulting in heart failure, and three had noncardiac causes of hydrops. In three cases, hydrops was caused by supraventricular tachycardia. One of these fetuses responded to cardioversion at birth, another responded to transplacental digoxin therapy, and the third died with atrial flutter and high-grade atrioventricular block before delivery. There were no cases of "idiopathic" hydrops. Our results show that fetal echocardiography is useful in determining cardiac causes of in utero heart failure resulting in hydrops fetalis. The fetal echocardiogram may also be used in monitoring transplacental therapy of heart failure.

Adolescent↗
PubMed1982

Use of intravenous Premarin in the treatment of dysfunctional uterine bleeding--a double-blind randomized control study.

Dysfunctional uterine bleeding results from disruption of the normal sequence of ovarian cyclic hormonal stimulation of the uterine endometrium. Treatment of dysfunctional uterine bleeding previously consisted of surgical or hormonal manipulation, or both. The present study was conducted on 34 patients in a randomized double-blind fashion to evaluate the efficacy of treating dysfunctional uterine bleeding with intravenous Premarin. Bleeding stopped in 72% of patients who received intravenous Premarin and in 38% who received placebo (P = .021). Premarin was effective in terminating endometrial bleeding in patients with biopsy-proved pathology consisting of secretory, proliferative, menstrual, polypoid, or cystic hyperplasia, as well as endometritis.

Adolescent↗
PubMed1982

In utero diagnosis of hydrops fetalis: ultrasound methods.

The advent of diagnostic ultrasound has now made it possible to evaluate early markers of developing fetal hydrops. Because of these developments, the recognition of these adverse findings can be treated and the disease process reversed. This has been done in cases of Rh disease by intervening intrauterine transfusion, by medically treating the fetal arrhythmias, and/or by treating the basic underlying maternal disorder. The ultrasound examination of the hydropic fetus must include a thorough evaluation for structural anomalies, which can best be accomplished at referral centers where Stage II ultrasound examinations can be carried out. Not all conditions associated with hydrops fetalis are lethal. We therefore believe that timed delivery and atraumatic birth are essential to ensure the optimal outcome.

Cesarean Section↗