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Biomedical subjects

J S Abramowicz

Publications and source records attributed to J S Abramowicz.

At least 37 records · Page 2Linked to original sources
PubMed1993

Ultrasonographic measurement of cheek-to-cheek diameter in fetal growth disturbances.

OBJECTIVE: Our purpose was to assess the value of the cheek-to-cheek diameter and the cheek-to-cheek diameter/biparietal diameter ratio in the ultrasonographic detection of abnormal fetal growth. STUDY DESIGN: The cheek-to-cheek diameter and cheek-to-cheek diameter/biparietal diameter ratio were examined in 21 small-for-gestational-age (< 10th percentile for estimated weight) and 87 large-for-gestational-age (> 90th percentile) fetuses. Statistical analysis consisted of Student's t test comparison between means and analysis of covariance for comparison of regression lines slope between these 108 fetuses and previously published nomograms of appropriate-for-gestational-age fetuses. RESULTS: The mean cheek-to-cheek diameters in small-for-gestational-age fetuses were significantly smaller than in appropriate-for-gestational-age fetuses (p < 0.0001). In large-for-gestational-age fetuses the mean cheek-to-cheek diameters were significantly larger (p < 0.005). Although large-for-gestational-age fetuses of diabetic mothers exhibited higher cheek-to-cheek diameter/biparietal diameter ratios than did appropriate-for-gestational-age fetuses (p < 0.0001), in fetuses of nondiabetic mothers this ratio was only minimally larger (p < 0.05). CONCLUSION: The cheek-to-cheek diameter and cheek-to-cheek diameter/biparietal diameter ratio are innovative ultrasonographic parameters for detecting abnormal fetal growth. Furthermore, the cheek-to-cheek diameter/biparietal diameter ratio permits insight into the possible underlying pathophysiologic mechanisms of fetal macrosomia.

Cephalometry↗
PubMed1993

Twin-twin transfusion with abrupt onset of microcephaly in the surviving recipient following spontaneous death of the donor twin.

We describe a case in which twin-twin transfusion with fetal death of the donor at 23 weeks was complicated by suspected intracranial embolic insult of the surviving recipient twin. Dynamic transient intracranial ultrasonographic findings were noted with complete resolution by 28 weeks. Subsequent severe microcephaly of the survivor with no further growth of any of the cranial parameters beyond 25 weeks was thought to be a result of this very unusual pathophysiologic mechanism.

Adult↗
PubMed1993

Physiology of isolated long-term variability of the fetal heart rate.

Ten singleton third trimester fetuses exhibiting isolated long-term variability of the fetal heart rate were studied with a single Doppler transducer actocardiograph in conjunction with real-time ultrasonography. Each of these studies revealed repetitive clustered bursts of fetal breathing movements during the acceleratory phases and apneic episodes during the deceleratory phases of this fetal heart rate pattern, respectively, in the absence of other fetal movements. This observation may explain the physiology of isolated long-term variability of the fetal heart rate.

Adult↗
PubMed1993

Twin-twin transfusion syndrome: rapid development of severe hydrops of the donor following selective feticide of the hydropic recipient.

Twin-twin transfusion syndrome is a serious complication of monozygotic twin pregnancies and is associated with high rates of perinatal morbidity and mortality. Unfortunately, therapies to disrupt the arteriovenous anastomoses are limited, and the success rate of these therapeutic modalities are poor. We present a case of severe twin-twin transfusion syndrome at 23 weeks' gestation in which selective feticide of the recipient hydropic twin by intracardiac injection of potassium chloride was followed by rapid development of hydrops in the donor twin.

Abortion, Induced↗
PubMed1993

Massive hydronephrosis mimicking theca lutein cysts in association with partial hydatidiform mole.

We present an unusual case of partial hydatidiform mole in which extensive, multiple cystic structures encompassing the entire right abdomen and pelvis, initially thought to represent theca lutein cysts, were subsequently shown to consist of massive unilateral right hydronephrosis. Percutaneous nephrostomy decompression bypassing the ureteropelvic obstruction revealed functional renal parenchyma.

Adolescent↗
PubMed1993

Fetal sacral length in the ultrasonographic assessment of gestational age.

OBJECTIVE: Our purpose was to establish a nomogram of fetal sacral length throughout gestation and to assess its value in cases of abnormal fetal growth. STUDY DESIGN: A prospective cross-sectional study of 506 singleton fetuses with normal growth between 15 and 41 weeks' gestation was performed. Regression analyses were performed on sacral length, gestational age, biparietal diameter, head circumference, and femur length. The sacral length in 80 singleton gestations with abnormal growth (40 > 90th percentile and 40 < 10th percentile for gestational age) were compared with the nomogram. RESULTS: Linear relationships between gestational age and sacral length, biparietal diameter, head circumference, and femur length were demonstrated. Sacral length (centimeters) as a function of gestational age (weeks) was expressed by the regression equation: Sacral length = -0.108 + 0.102 Gestational age, with a Pearson correlation coefficient of R2 = 0.959. The sacral length of all 80 fetuses with abnormal growth demonstrated the same relationship to gestational age as did the 506 normal controls. CONCLUSION: This study defines the normal limits of sacral length; demonstrates a high correlation between sacral length, gestational age, and other standard measurements of fetal growth; and indicates that sacral length can predict gestational age, irrespective of fetal nutritional status.

Cross-Sectional Studies↗
PubMed1993

Prenatal ultrasonographic diagnosis of intracranial teratoma and massive craniomegaly with associated high-output cardiac failure.

Congenital intracranial teratomas are rare and usually fatal. We present prenatal diagnosis of such a case associated with scalp, facial, and body skin edema, hepatomegaly, extramedullary hematopoiesis, polyhydramnios, and a hydropic placenta. These manifestations of high-output cardiac failure were thought to be the result of the large cardiac output required by massive intracranial tumor arteriovenous shunting.

Adult↗
PubMed1993

Extensive fetal intrathoracic injuries sustained in a motor vehicle accident.

Motor vehicle accidents are the primary nonobstetric cause of maternal and subsequent fetal mortality. We present a case in which blunt abdominal trauma sustained by a pregnant woman in a motor vehicle accident caused extensive intrathoracic fetal injuries consisting of bilateral hemothorax, severe bilateral interstitial pulmonary hemorrhages, hemopericardium, and subepicardial hemorrhages, in addition to fetal cranial injuries. To the best of our knowledge, this is the first report of fetal intrathoracic injuries sustained with blunt maternal trauma. The underlying mechanism of intrathoracic trauma was thought to be similar to that of blast injury with transmission of excessive hydrostatic forces throughout the amniotic fluid with severe impact on the elastic fetal chest. This case supports the concept of in utero blast injury to the fetus as a possible cause for fetal soft tissue trauma associated with blunt trauma to the maternal abdomen.

Accidents, Traffic↗
PubMed1993

Prenatal sonographic diagnosis of isolated distal amelia of an upper extremity.

We report a case of fetal amelia (limb deficiency). The causes of this anomaly include amniocentesis, amniotic band syndrome, teratogen exposure, or a vascular accident. Recently, chorionic villus sampling has also been implicated in the amputation of an extremity. Although chorionic villus sampling (CVS) was not performed in our case, this possible association suggests subsequent sonographic scanning following CVS should include precise delineation of all fetal limbs.

Adult↗
PubMed1993

Severe HELLP syndrome presenting with acute gum bleeding following toothbrushing at 38 weeks' gestation.

We describe a case of hemolysis, elevated liver enzymes and low platelet count (HELLP syndrome) at 38 weeks' gestation. This condition was diagnosed when the patient presented with acute, persistent gum bleeding after toothbrushing. Her platelet count was 26,000/mm3. Bleeding gums have rarely led to the diagnosis of this syndrome; this case appears to be the most severe description of this clinical presentation following toothbrushing yet presented in the literature. Although the patient had been hospitalized 48 hours earlier with nonspecific viral-like symptoms, she was discharged after being treated with intravenous hydration. Reexamination of laboratory studies obtained at the time of her first presentation revealed thrombocytopenia. The diagnosis of this syndrome could possibly have been made at that time. This case emphasizes the importance of maintaining a low threshold of suspicion for this syndrome.

Acute Disease↗
PubMed1993

Adult respiratory distress syndrome: a consideration with rapid respiratory decompensation in association with preeclampsia.

Adult respiratory distress syndrome, presenting as rapid respiratory decompensation in the setting of preeclampsia at 36 weeks of gestation, was managed by early hemodynamic monitoring with pulmonary artery catheterization. With confirmation of the diagnosis of preeclampsia the patient was delivered promptly; improvement of her respiratory failure was observed within 48 hours. Consideration of adult respiratory distress syndrome in the setting of preeclampsia is discussed, with emphasis on early confirmation of the diagnosis and determination of the precise mechanisms of pulmonary edema.

Adolescent↗
PubMed1992

An infant with trisomy 9 mosaicism presenting as a complete trisomy 9 by amniocentesis.

We present a case in which amniocentesis performed at 33 weeks' gestation because of symmetrical intrauterine growth retardation and decreased amniotic fluid volume led to the prenatal diagnosis of a fetus with a karyotype of 47,XX,+9,t(1;20)(q42;p11.2) pat, i.e., with an extra chromosome 9 and a balanced translocation between chromosomes 1 and 20. At delivery, the baby showed clinical features of trisomy 9, yet chromosome analysis of the cord blood revealed no trisomy 9 cells, a finding confirmed by neonatal blood karyotyping. The balanced translocation was present in all cells. A skin biopsy confirmed trisomy 9 mosaicism with 10 per cent trisomy 9 cells. The baby died at 6 weeks and an autopsy was obtained. Chromosome analysis of different organs demonstrated different frequencies of the mosaicism of trisomy 9. The possible underlying mechanism for the discrepancy between the karyotype results by amniocentesis and those of other tissues is discussed.

Adult↗