Biomedical subjects
Publications and source records attributed to I E Timor-Tritsch.
The fetal heart rate pattern of a dying fetus due to tightening of a true knot of cord is presented. Sinusoidal pattern was electronically recorded along wih bradycardia--tachycardia. The importance of the sinusoidal pattern is discussed. It seems to imply fetal compromise if observed together with other signs of moderate fetal distress.
The accuracy of estimating fetal weight with real-time ultrasonography was studied in 81 fetuses. The technique is described and results are compared with those obtained by the B-scan technique. The absolute mean error was 228 g or 8.3% of the mean weight. Sixty percent of the measurements fell within 10% of the actual birth weight. The estimates were more accurate in the low (less than 1500 g) and in the high (more than 4000 g) weight groups. The easy access, simple technique, and reasonable accuracy of realtime scanners, as well as the development in progress for more reliable instruments, enable us to advocate its value for estimation of fetal weight in the delivery suite.
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Fetal respiratory movements (FRM) were studied using abdominal strain gauges (tocodynamometers). The patterns of the FRM were evaluated during both active and quiet fetal time periods, which were determined by the fetal heart rate (FHR) and fetal body movement (FM). The FRM were classified into Regular and Irregular patterns based on neonatal respiratory criteria for sleep-state studies in the term infant. Evaluation of the breath-to-breath intervals (BBI) showed statistically significant respiratory differences during active and quiet fetal time periods. Irregular fetal respiratory movement patterns were noted during fetal active periods. It would appear that the correlation of regular fetal respiratory movement with fetal quiet periods in the term fetus adds additional evidence that a quiet sleep state may exist in the term fetus.
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A tocodynamometer applied to the maternal abdomen is used for monitoring human fetal respiratory movements (FRM). This provides a recording of fetal chest wall movements from which observations and measurements relating to fetal respiratory physiology may be made. The FRM must be differentiated from materanal vascular and respiratory movements, as well as fetal movements and cardiac pulsations. The technique lends itself to extended periods of observation, since it does not transmit energy to the fetus as in other techniques. The simplicity of the technique, combined with the use of monitoring devices already available in most hospitals, warrants further observation of this method of respiratory movement monitoring in the developing fetus.
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In normal pregnant women, the relationship between the FHR and fetal movements (FM) was evaluated during 1,541 consecutive observed FM of at least 1 second's duration. Two observed FHR changes were: (1) accelerations and (2) accelerations followed by decelerations. An acceleration in FHR was observed in association with 91.2 per cent of all FM of 1 to 3 seconds' duration and with 99.8 per cent of FM of longer than 3 seconds' duration. FM were associated with an acceleration followed by a deceleration 66.7 per cent of the time. FM lasting longer than 1 second and associated with neither accelerations nor decelerations were seen 1.8 per cent of the time.
We present and discuss major current theories about the developmental natural history of the anencephalic human fetus. We confirm previous observations made using transvaginal ultrasonography of exencephalic fetuses which were later imaged and/or delivered as anencephalic fetuses. We explore the possibility of proving the theory of the slowly rubbed-off exposed brain tissue by cytologic examination and special staining of aspirated cells in amniotic fluid. Three fetuses with a typical sonographic picture of exencephaly at 13-15 postmenstrual weeks underwent amniocentesis. The aspirated fluid contained pathognomonic neural cells. The same fetuses later showed the characteristic sonographic and postabortion picture of anencephaly. Our results support the theory that exencephaly is the forerunner of anencephaly.
Transvaginal sonography with a high-frequency probe, a recent development gaining clinical application, obtains better image resolution of deep pelvic organs. Uses of transvaginal sonography include diagnosis and treatment in gynecology, infertility, and early pregnancy. Acceptance by health-care providers and patients is widespread. Advantages include greater clinical capability, increased efficiency, and reduced costs. The nurse's role in patient education and management is a vital component of the care of the patient undergoing transvaginal sonography.
OBJECTIVE: We raise the issue of scanning multifetal pregnancies of higher order as early as possible. A rare case of monochorionic/quadramniotic pregnancy seeking multifetal pregnancy reduction and its clinical management is presented. METHODS: Transabdominal scanning at 16 weeks was performed correctly diagnosing the monochorionic quadruplet pregnancy. RESULTS: Suspecting vascular connections between the placentae, the fetal reduction was declined. The patient was delivered at 31 weeks. The 4 female neonates survived with slight ventilatory assistance. CONCLUSION: Multifetal pregnancies in general, but those of higher order in particular, have to be scanned as early as 8-10 weeks to correctly and easily assign their chorionicity and amnionicity. The case of a monochorionic/quadramniotic pregnancy and its clinical course are presented.