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Biomedical subjects

I Meizner

Publications and source records attributed to I Meizner.

At least 73 records · Page 4Linked to original sources
PubMed1993

Prenatal ultrasound diagnosis of a rare occurrence of lethal multiple pterygium syndrome in two siblings.

We report two cases of prenatal ultrasound diagnosis of the lethal form of multiple pterygium syndrome in successive pregnancies in the same woman. This extremely rare entity is characterized by multiple pterygia, flexion contractures, facial anomalies and hypoplasia of heart and lungs. The appearance of the congenital cataract is unique and this finding was present in both abortuses. Prenatal detection of this syndrome is feasible, and an ultrasound survey should be offered during genetic counselling to previously affected couples.

Journal Article↗
PubMed1993

[Early ultrasonic diagnosis of conjoined twins].

Conjoined twins is a rare congenital malformation occurring in 1:30,000-1:100,000 live births. Its early prenatal detection was extremely rare prior to the introduction of obstetric ultrasonography. We report 3 cases of early ultrasound diagnosis of conjoined twins at 9, 15 and 19 weeks of pregnancy, respectively. The diagnosis at 9 weeks of gestation was made via the transvaginal approach, and to the best of our knowledge is the earliest diagnosis reported in the English literature. In all 3 cases the fetuses were of the thoraco-omphalopagus type and had a shared heart. Pregnancy was discontinued in all 3 cases using methods appropriate for the first and second trimesters of pregnancy.

Abortion, Therapeutic↗
PubMed1993

Sonographic diagnosis of fetal congenital cataracts.

Five fetuses with congenital cataracts diagnosed in utero by ultrasound are reported. The fetuses, who were between 14 and 27 weeks' gestation, also had other severe malformations. The sonographic features of the cataracts are presented.

Adult↗
PubMed1993

The association between increased mean arterial pressure and abnormal uterine artery resistance to blood flow during pregnancy.

OBJECTIVE: To examine the relation between increased mean arterial pressure (MAP) and the uterine artery resistance index (RI) to blood flow in the third trimester of pregnancy. METHODS: One hundred consecutive patients in the third trimester whose pregnancies were complicated by hypertensive disorders, with or without proteinuria, had uterine artery resistance to blood flow measured using continuous-wave Doppler. RESULTS: The RI was in the normal range in 20 patients. Unilaterally abnormal RI was found in 32 and bilaterally abnormal RI in 46 (two subjects were excluded from this categorization because measurements were obtained from only one side of the uterus). A MAP below 100 mmHg was associated with a normal RI. All six subjects with MAP of 140 mmHg or greater had bilaterally abnormal RI. Mean arterial pressure values of 100-139 mmHg included 90% of the women with normal RI, 100% of those with unilaterally abnormal RI, and 87% of those with bilaterally abnormal RI. Proteinuric and nonproteinuric groups differed with respect to both MAP (P = .04) and RI (P = .01). Pregnancy outcome was less favorable in the unilaterally abnormal RI subgroup than in the normal RI subgroup. The bilaterally abnormal subgroup of patients had the most adverse pregnancy outcomes. CONCLUSIONS: Pregnant patients in the third trimester who have increased MAP but a normal uterine artery RI can expect a good pregnancy outcome. Increased MAP associated with abnormal uterine artery RI may result in an unfavorable pregnancy outcome, particularly in those with bilaterally increased RI to blood flow. Doppler measurement of uterine artery impedance is recommended in pregnancies complicated by hypertensive disorders.

Adult↗
PubMed1992

[Resistance in uterine arcuate arteries of pregnant hypertensive patients].

Hypertensive pregnant women were examined by continuous Doppler-ultrasound to measure resistance to blood flow in the uterine arcuate arteries. 20/26 had increased resistance. Those with bilateral increased resistance delivered after a mean of 33.2 weeks of pregnancy, 46.1% of them by cesarean section, and the mean birthweight was 1743 g. Those with unilateral increased resistance delivered after a mean of 38.0 weeks, 28.5% by cesarean section, and the mean birthweight was 2813 g. Measurement of blood flow by the Doppler method seems to be useful in the management of hypertensive disorders in pregnancy, as it helps to assess deficiency of the uterine circulation.

Arteries↗
PubMed1992

Flow velocity analysis of umbilical and uterine artery flow in pre-eclampsia treated with propranolol or pindolol.

In a double blind study, 20 gravidas with pre-eclampsia were randomly allocated to treatment with either propranolol 120 mg/day or pindolol 15 mg/day for 7 days. Flow velocimetry was performed before and after treatment to assess the influence of these two regimens of beta blocker on the feto-placental circulation. A continuous wave Doppler unit was used to measure umbilical and uterine artery flow velocity waveforms. The systolic/diastolic (A/B) ratio and the systolic minus diastolic divided by systolic (A-B)/A ratio (resistance index) were used as indexes of blood flow resistance in the umbilical and uterine arteries, respectively. A resistance to flow in the uteroplacental circulation was significantly less in patients treated with pindolol compared to those treated with propranolol (P less than 0.01). The same pattern was also found in umbilical velocimetry, although the statistical significance was borderline (P = 0.06). Although both drugs were equally effective in reducing blood pressure at rest, their effect on the peripheral resistance was different. Pindolol appears to act in part through a peripheral vascular mechanism. Our data support this assumption because the flow in the uteroplacental bed, as reflected by a decrease in resistance index, improved when patients were treated with the drug pindolol.

Adult↗
PubMed1992

Prenatal ultrasonographic diagnosis of fetal scrotal inguinal hernia.

Fetal scrotal inguinal hernia was diagnosed at 33 weeks of pregnancy by ultrasonographic examination. Moving, echo-free, cystlike structures representing peristalsis within trapped loops of bowel in an abnormally enlarged scrotum were the main ultrasonographic finding. The diagnosis was confirmed post partum, and surgery was successfully carried out 4 days after delivery.

Female↗
PubMed1992

Cordocentesis in the evaluation of the growth-retarded fetus.

The direct access to the fetal circulation provided by cordocentesis enables a better understanding of physiologic changes and more efficient diagnosis and treatment of many pathologic conditions. Because the procedure of direct fetal blood sampling is relatively safe, it has great potential in both antepartum surveillance and treatment of the severely growth-retarded fetus. Ultrasonography and Doppler instruments are the basis for urgently needed therapeutic trials which most probably will provide the obstetrician with new tools to treat the IUGR fetus early enough to prevent fetal compromise. Intrauterine infusion of nutrient supplements and methods to improve fetal acid-base balance may eventually be incorporated into the management protocols of the jeopardized growth-retarded fetus.

Blood Specimen Collection↗
PubMed1992

Iniencephaly. A case report.

Prenatal ultrasound diagnosed iniencephaly apertus at 21 weeks' gestation. In this rare central nervous system (CNS) malformation the brain and neck show the main pathologies. Retroflexion of the head with exaggerated cervicothoracic lordosis is always present, and CNS malformations in the form of anencephaly, spina bifida and encephalocele are often present. The ultrasonic diagnosis should be based on the finding of extreme dorsiflexion of the head accompanied by an abnormally short and deformed spine.

Abortion, Therapeutic↗
PubMed1991

Fetal ovarian cysts: prenatal ultrasonographic detection and postnatal evaluation and treatment.

Ovarian cysts were diagnosed by antenatal ultrasonographic examination in 15 fetuses between 19 and 37 weeks' gestation. In six cases there was ultrasonographic evidence of torsion. Intracystic flocculation, which typically was deposited on the sloping part of the cyst, gave a characteristic liquid interface that was regarded as ultrasonographic evidence of torsion. All cases with evidence of torsion were managed surgically post partum, and in all patients this complication was confirmed. The remaining nine cases were followed up by repeated ultrasonograms, and in all patients disappearance of the cyst was documented within the first 6 months of life. The mean size of cysts with evidence of torsion was 5.41 +/- 0.25 cm, and the mean size of those without torsion was 4.33 +/- 0.3 cm (p less than 0.01). Histologic examination of the surgical specimen in the cases with evidence of torsion revealed follicular cysts in three cases and necrotic ovarian cysts with no specific epithelial findings in the remaining three. We recommend continuous ultrasonographic assessment of antenatally diagnosed cysts and believe that the choice of treatment depends on the appearance of the cyst and its evolution throughout pregnancy.

Female↗
PubMed1991

Torsion of uterine adnexa in neonates and children: a report of 20 cases.

Twenty children under the age of 14 years with torsion of the uterine adnexa are discussed. Of the 14 postnatal cases, 8 were associated with additional ovarian pathology whereas in 6 cases the torsion was of normal uterine adnexa. Six additional cases had antenatal torsion with "pseudocyst" formation. All 14 postnatal cases presented as acute abdominal emergency requiring immediate surgery. Only 6 of the 14 had been correctly diagnosed preoperatively, the rest being mostly diagnosed as acute appendicitis. Sonographic studies can improve the preoperative diagnosis. Hemorrhagic necrosis of the adnexa (secondary to the torsion) was found in all cases except one, and necessitated adnexal resection. In only one case preservation of the adnexa was possible. Fixation of the contralateral ovary is recommended in cases of torsion of normal uterine adnexa. All six cases of antenatal torsion were diagnosed by routine ultrasonography during pregnancy between the 29th and 40th week of gestation. The "fluid-fluid" level sign is characteristic of this lesion. These neonates were born in no acute distress and were found to be completely asymptomatic. Hence, they did not require urgent surgery and underwent operation electively at the age of 2 weeks. Resection of the pseudocyst with fixation of the contralateral ovary is the treatment of choice in these cases.

Abdomen, Acute↗