Biomedical subjects
Publications and source records attributed to I Meizner.
Uterine fundal and low segment arcuate artery velocimetry was studied in normal pregnant women and in severe preeclamptic patients. The waveform velocity of the preeclamptic group revealed large differences between systole and diastole, as well as an increased resistance index. Furthermore, the abnormality was more severe in the fundal than in the low segment arcuate measurement.
Changes in fetal activity ranging from reduction to cessation of fetal movements were observed in patients at the 25th to 34th week of gestation, who were receiving steroids for enhancement of fetal lung maturation. This was a transient phenomenon, and fetal movements returned to normal by 24 h after the last injection of steroids. Concomitantly, during the period of exposure to steroids, we found an increased incidence of nonreactive monitoring patterns on daily analysis of fetal heart monitoring tracing. Although the pathophysiology of these changes is still unclear, we believe that the practical value of this observation is of importance. Reduction or cessation of fetal movements and a nonreactive nonstress test are generally accepted signs of fetal compromise and considered as an indication for termination of pregnancy. In this selective group of patients this is a temporary phenomenon; therefore, conservative management would seem in order.
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A continuous wave Doppler unit was used to obtain umbilical and uterine artery flow velocity waveforms in pregnancies complicated by a major fetal abnormality. A total of 139 examinations were performed on 32 women between 26 to 41 weeks' gestation, and the records were reviewed to determine the changes associated with fetal malformation. The systolic/diastolic (A/B) ratio was used as an index of blood flow resistance in the umbilical artery and the systolic minus diastolic divided by systolic (A-B)/A for the branches of the uterine artery. Seventeen out of 32 patients showed high systolic/diastolic ratio in waveforms taken from the umbilical artery. In 30 out of 32 patients the uterine artery waveform was normal (in two patients the results were equivocal). It appears that a fetal mechanism may determine the changes in the umbilical placental circulation resulting in an umbilical artery pattern of high flow resistance in more than half of the patients with congenital anomalies.
Considerable evidence indicates that changes in acid phosphatase (AP) activity at the ovarian level play a role in the process of ovulation. In this study the concentrations of AP were determined in follicular fluids collected from follicles of 52 women at the time of laparoscopy performed in connection with an in vitro fertilization program. In each of the 52 women at least one ovum was harvested. Of the 52 ova, 28 cleaved in vitro, while in 24 ova cleavage was not seen. Levels of AP in follicular fluids of women whose ova did not cleave were significantly lower than those found in follicular fluids of women with at least one ovum undergoing cleavage: 0.45 +/- 0.14 (SE) and 4.78 +/- 0.37 Bess Lowry Units (BLU), respectively. Comparison of AP levels in follicular fluids of women who conceived (5) and women whose ova cleaved, but in whom pregnancy was not achieved (23), did not reveal significant differences: 5.87 +/- 1.29 and 4.55 +/- 0.35 BLU, respectively. Moreover, the enzyme level was typical for a woman and not for a follicle. Fluids of two different follicles of the same woman, when one ovum cleaved and one did not, showed similar AP levels. AP levels were high in all samples follicles of women in whom at least one ovum cleaved. These findings indicate that the presence of certain levels of acid phosphatase represents an important, albeit not the sole, condition for ovum maturation. Moreover, the follicular fluid levels of AP could serve as an indicator of proper timing of the follicular puncture in relation to the human chorionic gonadotropin injection (or the luteinizing hormone peak).
A prospective study was made in 153 patients with a second stage of labour lasting 1 to 120 min. Maternal venous, umbilical artery and vein blood were analysed for acid-base variables and lactate levels. Blood was obtained immediately at delivery. Fetal heart rate monitoring data and blood test results were related to the duration of the second stage of labour and clinical outcome. In primiparae and multiparae there was a steady rise in umbilical artery lactate levels, with duration of second stage of labour, P less than 0.025 and P = 0.023, respectively. The median umbilical artery pH decreased significantly from 7.31 in patients with a second stage of labour that lasted less than or equal to 15 min to a pH of 7.25 in patients with a second stage of labour that lasted more than 30 min. Changes in PO2 and PCO2 were not statistically significant.
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Abnormalities of the fetal face were diagnosed prenatally by ultrasound in six cases. These included four cases of cleft lip and palate, one case of cyclopia with holoprosencephaly, and one case of fetal facial hemangioma. Of the fetuses with cleft lip and palate, one had trisomy 13, and one had Pierre Robin syndrome. Facial anomalies detected by ultrasound may suggest the presence of other accompanying malformations and may sometimes warrant chromosomal studies. Thus, careful imaging of the fetal face is an important part of ultrasound examination when evaluating the fetus at risk.
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