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Biomedical subjects

J Shalev

Publications and source records attributed to J Shalev.

At least 91 records · Page 5Linked to original sources
PubMed1987

Rescue of menotrophin cycles prone to develop ovarian hyperstimulation.

In an attempt to prevent the loss of 'overstimulated cycles' associated with human menopausal gonadotrophin (hMG)-induced ovulation, oestradiol levels and ovarian follicular state were monitored in 12 women with 'overstimulated cycles' after withholding hMG for several days. Human chorionic gonadotrophin (hCG) was administered when oestradiol levels were less than or equal to 1700 pg/ml and the leading follicles between 17 and 22 mm in diameter. During the withholding period follicular growth continued in all patients, while oestradiol levels declined in all but three. These three patients conceived. Ovulation was observed in six additional women. Ovarian hyperstimulation did not occur in any of the 12 patients. We conclude that a rescue of 'overstimulated cycles' is sometimes possible. Conception seems to depend on a continuing rise of E2 levels and early detection of 'overstimulation'.

Chorionic Gonadotropin↗
PubMed1986

Impact of a protocol for external cephalic version under tocolysis at term.

We present our experience with 60 trials of external cephalic version under tocolysis (EVT) performed on 58 women with uncomplicated (low-risk) pregnancies at term (37 to 42 weeks) during a 10-month period. Version was successful in 67.2% of the subjects (70.7% of trials). Fetal well-being was monitored before, during and after the procedure by cardiotocography and real-time ultrasound (RTUS). No analgetic or anesthetic medication was administered. Transient fetal bradycardia was recorded in 18 women. No major complications were noted. Compared with the period preceding the protocol, the breech rate declined during the study period by 1.02% (P less than 0.02) with a parallel decline of 1.12% (P less than 0.001) in the low-risk breech group affected by the protocol. The cesarean section rate for low-risk breeches fell from 1.85 to 0.89% (P less than 0.001), while the overall cesarean section rate decreased from 10.15 to 9.1% (not significant). We conclude from our experience and previous studies that EVT/RTUS is a reasonable alternative in the management of pathological presentations near term, provided that only low-risk pregnancies are included, and analgesia or anesthesia for external version under tocolysis is avoided.

Breech Presentation↗
PubMed1986

Subtle abnormalities in follicular development and hormonal profile in women with unexplained infertility.

A prospective study of six unselected couples diagnosed as having unexplained infertility was done. In three of six patients, subtle abnormalities in follicular development were detected. In the first case poor follicular growth was observed. There was a premature small rise of luteinizing hormone (LH) with subsequent low levels of estradiol (E2) in the late follicular phase and unusual wide LH peak. This was followed by low progesterone levels in the luteal phase. In the second case follicular growth was abrupted by premature LH surge. This surge was triggered by early rise of E2 level while the follicle was still small in size. In the third case luteinized unruptured follicle syndrome was diagnosed, on ultrasound examination. All of the abnormalities were repetitive.

Adult↗
PubMed1984

Breast engorgement and galactorrhea after preventing premature contractions with ritodrine.

Breast engorgement and galactorrhea were observed in many patients receiving ritodrine treatment to delay labor due to premature contractions. In an attempt to understand the causes for these phenomena, serum prolactin, progesterone, estradiol and estriol excretion were measured in 11 women. No statistical difference was found in these parameters after ritodrine administration. It can thus be assumed that breast engorgement and galactorrhea after ritodrine treatment are unrelated to changes in these hormones but might be mediated by some other factors or probably by the premature contractions themselves.

Adult↗
PubMed1984

Torsion of the ovary: sonographic features.

The sonographic findings in 19 cases of surgically proven torsion of the ovary are described. In all cases the affected ovary was markedly enlarged; in 32% of cases a small amount of fluid was detected in the cul-de-sac. More significant in terms of specificity was the demonstration in 14 (74%) of the 19 cases of small cystic structures scattered around the periphery of the organ. Sonographic demonstration of these structures, presumably prominent follicles, can suggest the preoperative diagnosis of ovarian torsion.

Adult↗
PubMed1983

Mid-trimester diagnosis of bladder neck obstruction by ultrasound and paracentesis.

A bladder neck obstruction was suspected after ultrasound investigation at 16 weeks' gestation. Evaluation of protein content in the amniotic fluid, fetal ascites, and fluid from the overdistended bladder supported the diagnosis. Bladder outflow obstruction in the second trimester of pregnancy was not associated with raised alphafetoprotein levels in the amniotic fluid and maternal serum.

Abortion, Therapeutic↗
PubMed1982

The prenatal ultrasonic diagnosis of urethral obstruction and diverticulum of the urinary bladder.

In a 28 year old gravida 2 para 1 an ultrasonogram at 35 weeks of gestation revealed a huge cystic abdominal tumor in fetus. Postpartum ultrasound, excretory urography and micturating cystourethrography showed a trabeculated bladder with a large diverticulum and hydronephrosis due to a posterior urethral valve. The prenatal diagnosis of this anomaly and immediate surgical intervention prevented additional severe damage in the newborn.

Adult↗
PubMed1982

Elective cervical suture of twin pregnancies diagnosed ultrasonically in the first trimester following induced ovulation.

The efficiency of elective cervical suture in preventing premature delivery thus reducing neonatal mortality was studied in a group of 50 twin pregnancies. All pregnancies occurred after induction of ovulation and twins were diagnosed early by ultrasound. 25 randomly selected patients underwent elective cervical suture. 22 sutured and 23 non-sutured patients were followed until delivery, while 5 patients aborted in the second trimester. The benefit of suturing on the duration of pregnancy and its outcome were assessed. Of the sutured patients, 10 (45.4%) delivered prematurely and the neonatal death rate was 18.2%. In the non-sutured patients, 11 (47.8%) delivered prematurely and the neonatal death rate was 15.2%. This study demonstrates that elective cervical suture was not effective in prolonging gestation or improving fetal outcome in twin pregnancies following induced ovulation.

Adult↗
PubMed1982

Continuous sonographic monitoring of IUD extraction during pregnancy: preliminary report.

The significance of the location of intrauterine contraceptive device in relation to the gestational sac on pregnancy outcome was studied in 13 pregnant women after extraction of the device. Of the seven women (group 1) who had the intrauterine contraceptive device removed after initial localization by sonography, two (28.5%) miscarried. In both cases the device was located cephalad or lateral to the gestational sac. In six women (group 2) continuous sonographic scanning was undertaken to visualize the extraction procedure. Traction on an intrauterine device located laterally (two cases) or cephalad (one case) to the gestational sac was followed by distortion of the sac configuration. Gentle intermittent traction on the contraceptive device resulted in successful extraction procedure. These preliminary observations suggest that pregnancies with an intrauterine contraceptive device located laterally or cephalad to the gestational sac are at greater risk during extraction of the device. Sonographic monitoring of the extraction procedure during pregnancy may minimize the hazards of intrauterine contraceptive device failure.

Abortion, Spontaneous↗
PubMed1980

Uterine perforation during curettage: perforation rates and postperforation management.

Over a period of eight years, 13,344 consecutive patients underwent curettage in our hospital for various indications. Uterine perforation occurred in 22 (0.16%) of them. An additional seven patients were admitted with existing uterine perforation. The most common site of perforation was the uterine fundus and the instrument most often involved was a sharp curette. The perforation rates in curettage performed for postpartum hemorrhage and intrauterine adhesions were relatively high (5.1 and 1.8%, respectively); the rates in those for elective abortion and postmenopausal bleeding were intermediate (0.4 and 0.2%, respectively); and in those performed for other indications, the rate was very low (less than or equal to 0.06%). After uterine perforation occurred 15 patients (51.7%) were managed by observation only and the course was uneventful. In 10 patients (34.5%), exploratory laparotomy was performed; in three of them, no active bleeding organ injury was found. Judicious use of laparoscopy after uterine perforation allows proper selection of patients for further surgery.

Curettage↗