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Biomedical subjects

L C de Crespigny

Publications and source records attributed to L C de Crespigny.

At least 37 records · Page 2Linked to original sources
PubMed1985

Vault haematoma after vaginal hysterectomy: an invariable sequel?

Fifty consecutive patients undergoing vaginal hysterectomy were studied prospectively by ultrasound to determine the incidence of vault haematoma and the relationship between its size and the development of postoperative pyrexia; 49 patients (98%) had a vault haematoma and 35 (70%) were febrile postoperatively. Large vault haematomas (mean diameter greater than 5 cm) were invariably associated with significant febrile morbidity, whilst 1 in 3 patients with a small haematoma was afebrile. Colporrhaphy did not influence the likelihood of haematoma formation.

Female↗
PubMed1985

Ultrasound-guided puncture for gynaecological and pelvic lesions.

A series of 34 patients who underwent a total of 37 ultrasound-guided cyst punctures and fine needle biopsies for diagnosis and treatment of pelvic lesions are reported. In all but 1 patient the lesion visualized was entered and cytological diagnosis was achieved, although 1 patient required a second attempt under general anaesthesia. Seven cysts were endometriotic; these and all the remaining cysts were benign and only 4 patients developed a recurrence of the cyst following puncture. No patient in whom the ultrasound appearance suggested a benign cyst was found to have an ovarian malignancy. Three patients with malignant lesions had a total of 4 punctures or biopsies and a final patient had a fine needle biopsy of an ovary to exclude malignancy.

Adult↗
PubMed1985

Ventricular size in newborn infants.

Cranial ultrasound examinations were performed on 533 infants of between 48 and 96 hours of age to establish the range of ventricular size in neonates of different gestational ages in whom there was no evidence of intraventricular hemorrhage or neural tube defects. It was found that ventricular size did not vary in infants with gestational age of 26 weeks or more. Only 15 (2.8 per cent) neonates had a ventricular width of greater than 3 mm. Of these 15 infants, 13 were re-examined within the first year of life and found to be neurologically and developmentally normal.

Anthropometry↗
PubMed1985

Ultrasound-guided fetal blood transfusion for severe rhesus isoimmunization.

Four fetuses with severe rhesus isoimmunization were transfused with packed red blood cells directly into the umbilical vein. The outcome was successful in three. In one infant, this ultrasound-guided technique resulted in resolution of severe fetal hydrops at 27 weeks, allowing delivery of a healthy nonhydropic infant at 33 weeks, and in the other three infants in prolongation of the pregnancy. The last four transfusions were performed after fetal neuromuscular blockade with curare. The procedure would appear to be associated with a low risk of complication and to provide an excellent chance of a successful outcome of a fetus with severe rhesus isoimmunization even when fetal hydrops is present.

Blood Transfusion, Intrauterine↗
PubMed1984

Pregnancy after percutaneous transvesical ultrasound-guided follicle aspiration for in-vitro fertilization.

A case, in which pregnancy (unfortunately ectopic) followed oocyte collection by an ultrasound technique, is reported. Nevertheless, the procedure is less invasive than laparoscopic follicular aspiration, does not require general or major regional anaesthesia, and is suitable for patients in whom access to the ovaries by means of laparoscopy is either not possible or severely restricted.

Adult↗
PubMed1983

Can obstetricians prevent neonatal intraventricular haemorrhage?

The possible influence of obstetric and early neonatal factors on the development of neonatal intraventricular haemorrhage (IVH) in very low birth-weight infants have been studied. Caesarean section was associated with a significantly lower incidence of IVH, this reduction being largely confined to infants of 25-28 weeks' gestation. Forceps delivery did not seem to influence the rate of occurrence of IVH if one allowed for differences in gestational age between infants delivered spontaneously and those with forceps. Similarly the use of an episiotomy at the time of delivery did not seem to reduce the incidence of IVH, and a similar lack of correlation was found with the other factors examined.

Cerebral Hemorrhage↗
PubMed1983

Ectopic pregnancy.

Ectopic pregnancy remains a significant contributor to maternal mortality and morbidity. Despite the obstetrician's awareness of the problems, ectopic pregnancy in many cases still remains a difficult diagnosis. Over the last 10 to 15 years diagnostic ultrasound has become an established means of supplying additional and occasionally diagnostic information on those patients suspected of having an ectopic pregnancy. In essence diagnostic ultrasound can provide information regarding the presence of an intra-uterine pregnancy, a finding which goes a long way to excluding an extra-uterine pregnancy, and can show that there is no gestation sac within the uterus, a finding which raises the level of suspicion of an ectopic pregnancy. In addition to these primary uses, diagnostic ultrasound can also provide information relating to the presence or absence of both an adnexal mass and free fluid in the pouch of Douglas. All of these features, however, are open to error and their appreciation leads to a more rational approach to the interpretation of the overall ultrasound findings. In using diagnostic ultrasound in at-risk patients, side-room urinary pregnancy tests, and if necessary the more sophisticated radioimmunoassays of beta-subunit hCG, should be used in conjunction. From the authors' own studies it was concluded that an empty uterus with an adnexal mass and/or the presence of free fluid in the pelvis, together with positive biochemistry, was able to give a very high level of diagnostic accuracy for ectopic pregnancy (95 per cent). However, an empty uterus alone in the absence of an adnexal mass or free fluid in the pelvis was not of itself a reliable guide to the presence of an ectopic pregnancy even in the presence of positive biochemistry. The finding of a living fetus outside the uterus was an uncommon event (6 per cent), but if present allows an absolute diagnosis of ectopic pregnancy. Finally a negative serum hCG assay virtually excludes the possibility of an ectopic pregnancy. A scheme involving the use of urine pregnancy testing, serum hCG assays and ultrasound has been proposed for the rational management of patients suspected of having an ectopic pregnancy and whose condition is stable. In all circumstances, however, it is stressed that should the patient's condition so warrant then surgical intervention is mandatory irrespective of the ancillary findings.

Adnexa Uteri↗
PubMed1982

Timing of neonatal cerebroventricular haemorrhage with ultrasound.

Sequential real-time ultrasound examinations were performed in 174 neonates to determine the time of occurrence of cerebroventricular haemorrhage (CVH). Of the 47 infants in whom CVH was detected, in 36 (77%) CVH was present at the first examination. Of the 34 infants with CVH who were examined first within 6 hours of birth, 24 (71%) already had haemorrhage demonstrable at the initial scan. Extension of a CVH after its initial detection occurred in only 3 infants. Of 124 consecutive infants of birthweights less than 1500 g, 38 (31%) developed CVH, 56% of the outborn and 27% of the inborn babies. Our results indicate that most infants who develop CVH have done so within 6 hours of birth.

Cerebral Hemorrhage↗
PubMed1981

Determination of fetal sex with ultrasound.

In a consecutive series of 137 pregnancies scanned at 24 weeks' gestation or later, the sex of 66% of infants was determined with a 2% error rate. By means of ultrasound examinations, parents may now be offered the opportunity of knowing the sex of their baby before delivery.

Female↗
PubMed1981

Ultrasonic observation of the mechanism of human ovulation.

Nine subjects were studied by means of ultrasound to determine the precise time of ovulation and to document follicular changes immediately prior to, during, and after rupture. There were no demonstrable changes in the size of appearance of the follicle over a period of up to 7 hours prior to its rupture. In one of the four subjects in whom follicular collapse was witnessed, the follicle emptied completely within less than 1 minute. In two of the other three subjects, there was an initial rapid loss of fluid followed by a flower release of the remaining contents. This latter process took 7 minutes in the first patient and 35 minutes in the second patient. The slow phase of follicular collapse may well be an important aspect in the release of the ovum. The corpus hemorrhagicum was seen to develop within 1 hour of ovulation.

Female↗
PubMed1981

Ultrasound control of clomiphene/human chorionic gonadotropin stimulated cycles for oocyte recovery and in vitro fertilization.

Three pregnancies have been achieved through in vitro fertilization (IVF) following clomiphene/human chorionic gonadotropin (hCG) stimulation monitored only with ultrasound. When the results of 120 stimulated cycles were compared with those from 213 spontaneous cycles during a one-year period, the clomiphene-ultrasound-hCG method led to a significantly higher laparoscopy rate as well as significantly better yields of mature oocytes and embryos for intrauterine transfer. The luteal phase was normal in the stimulated group. This ultrasound-monitored technique was simpler to manage and less costly and appears to be the current method of choice for obtaining oocytes for IVF.

Chorionic Gonadotropin↗