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M Bronshtein

Publications and source records attributed to M Bronshtein.

At least 91 records · Page 5Linked to original sources
PubMed1992

Clubfeet associated with hydrocephalus: new evidence of gradual dynamic development in utero.

Clubfoot, a relatively frequent congenital malformation, may be associated with several genetic syndromes or other malformations, or may appear as an isolated idiopathic anomaly. We describe the intrauterine development of clubfeet subsequent and in parallel to fetal hydrocephalus formation, as followed by serial transvaginal sonographic scans at 11-16 weeks' gestation. The possibility of a causal relationship between the central nervous system malformation and the clubfeet is suggested. To the best of our knowledge, this is the first description of the dynamic, in vivo fetal development of hydrocephalus and clubfeet at 11-16 weeks' gestation.

Adult↗
PubMed1991

First- and early second-trimester oligohydramnios-a predictor of poor fetal outcome except in iatrogenic oligohydramnios post chorionic villus biopsy.

Whereas a well-known association exists between oligohydramnios and renal agenesis, renal dysplasia, urinary tract obstruction and intrauterine growth retardation in the second half of pregnancy, the causes and prognosis of early oligohydramnios are less known. Twelve cases of first- and early second-trimester oligohydramnios were detected out of 5000 fetal screenings for malformation detection. Two out of these 12 cases occurred in patients who had undergone chorionic villus sampling, two were associated with premature rupture of membranes, six were associated with fetal cardiac malformations and two cases were idiopathic. Whereas ten out of 12 cases ended in intrauterine fetal death, spontaneous or therapeutic abortions, in the two cases which developed after chorionic villus sampling the oligohydramnios was self-limiting and these two pregnancies ended in term deliveries of normal, healthy neonates. It may be concluded that oligohydramnios in the first half of gestation bears a poor fetal prognosis except in cases where it follows chorionic villus sampling.

Journal Article↗
PubMed1991

Early transvaginal sonographic diagnosis of alobar holoprosencephaly.

Holoprosencephaly is a cerebral anomaly resulting from incomplete cleavage of the primitive prosencephalon or forebrain. Early detection of this anomaly is very important since the most severe form is incompatible with life. The diagnosis also signals the need for a chromosomal determination since chromosomal abnormalities have been associated with this anomaly. An early diagnosis of alobar holoprosencephaly at 14 weeks' gestation, employing transvaginal sonography, is reported. Our findings are compared with prenatal transabdominal sonographic findings of holoprosencephaly which have been reported during the last decade in the literature.

Adult↗
PubMed1991

Pseudoprognathism--an auxiliary ultrasonographic sign for transvaginal ultrasonographic diagnosis of cleft lip and palate in the early second trimester.

Cleft lip and palate have been diagnosed antenatally only in the late midtrimester or at later gestational ages, when it is too late for pregnancy termination. The diagnosis of fetal cleft lip was made in three low-risk nulligravid women at 14 to 16 weeks of gestation by systematic screening with a 6.5 MHz transvaginal transducer and was confirmed by postabortal examination.

Adult↗
PubMed1991

Transvaginal sonography in infertility and assisted reproduction.

This review on transvaginal sonographic uses in the diagnosis and treatment of infertility evolves from the plethora of data acquired due to the renewed technology of TVS. A combination of its advantages: 1) closer proximity to the pelvic organs and therefore clearer images as compared to abdominal ultrasound, 2) the avoidance of the necessity of full bladder made the TVS gain much popularity in obstetrics and gynecology. Its value is recognized not only by opening a door to early detection of common pathologies of pregnancy--ectopic gestation and fetal malformations, multiple fetuses, and spontaneous fetal reduction ("vanished twin"), but also made visualization of the enlarged fallopian tubes, uterine cervix and corpus and ovarian follicles an almost indispensible adjunct to modern gynecologic infertility workup. The value of TVS seems to increase tremendously not only as an indispensible diagnostic tool but also as a modern means of replacing laparotomy or laparoscopy for follicular aspiration and eggs retrieval for IVF/ET, GIFT and assisted reproduction, reduction of the number of multiple fetuses, and for treatment of most cases of ectopic pregnancy. Its value in the diagnosis and treatment of the infertile couple seems invaluable now and indispensible tomorrow.

Female↗
PubMed1991

Hemorrhagic ovarian cyst detection by transvaginal sonography: the great imitator.

The sonograms of 102 hemorrhagic ovarian cysts (HOC) were reviewed to ascertain the full spectrum of sonographic findings as visualized by transvaginal sonography (TVS). The diagnoses, in 11 cases, were proven by surgery and the rest have undergone conservative follow-up until resolution (clinically and sonographically). The accurate diagnosis of HOCs by transabdominal sonography is quite difficult. The appearance of these cysts as visualized by TVS is described. We advise TVS as a better means for identification of HOCs, thus decreasing the rate of diagnostic invasive procedures.

Adolescent↗
PubMed1991

First- and second-trimester diagnosis of fetal ocular defects and associated anomalies: report of eight cases.

Ocular cataract, hypertelorism, hypotelorism, anophthalmos, and microphthalmos are rare malformations commonly associated with other fetal anomalies. Previously, ocular malformations were detected only after mid-gestation. Transvaginal sonography allows the detection of many structural fetal anomalies. We describe the case reports of eight ocular anomalies among 1600 fetal screenings by transvaginal sonography at 12-18 weeks' gestation. Severe cataract was correctly diagnosed by transvaginal sonography. However, transvaginal sonography failed to detect moderate cataract in a case of repeat cataract in a subsequent gestation. Anophthalmia may sometimes be secondary to a degenerative process in middle and late pregnancy. In five of the eight described cases, the eye malformations were associated with defects of the central nervous system.

Adult↗
PubMed1990

Roberts syndrome or "X-linked amelia"?

We report on a syndrome of tetra-amelia, facial clefts, absence of ears, nose, and atresia ani, affecting 7 male infants or fetuses in one Arab Moslem kindred. The combination of anomalies described in each affected member is consistent with Roberts syndrome and the prevalence of intermarriage in this kindred could suggest an autosomal recessive mode of inheritance. Alternatively, the existence of a new syndrome, namely, "X-linked amelia" is proposed.

Abnormalities, Multiple↗
PubMed1990

Transvaginal sonographic measurement of fetal kidneys in the first trimester of pregnancy.

Fetal renal size late in the first trimester of pregnancy was evaluated by transvaginal ultrasonography in 50 patients not at risk for congenital kidney disease and whose pregnancies resulted in a normal outcome. Both kidneys were reliably identified in all patients scanned at 12 weeks, 13 weeks, and 14 weeks, menstrual age. Kidney diameter measurements obtained in this study are presented for reference in evaluating patients in late first trimester whose fetuses are at risk for kidney abnormalities.

Adolescent↗
PubMed1990

Early determination of fetal sex using transvaginal sonography: technique and pitfalls.

Transvaginal sonography (TVS) enables sex determination at an early stage of pregnancy. The morphologic features of fetal external genitalia at 13 weeks to 16 weeks, menstrual age, are different from those seen later in pregnancy; therefore an attempt to determine fetal gender at this early stage by the same criteria as those used later is hazardous, especially for determining the male sex. The main diagnostic criteria for male gender determination by TVS are the "dome" sign representing the sonographic visualization of the fetal scrotum, the cranially directed phallus, and the longitudinal raphe at the base of the penis. The diagnostic criteria for female gender are the 2 or 4 parallel lines representing the labial folds and the caudally directed phallus (clitoris). The length of the fetal phallus at this early stage is not diagnostic and may be the main pitfall to the unexperienced sonographer. Between weeks 13 and 14 sex diagnosis was possible in 130/171 pregnancies (76%) in our first 2 years and 188/235 (80%) in our last 2 years of experience. Between weeks 15 and 16 sex diagnosis was possible in 122/139 pregnancies (88%) during our first 2 years and 96.7% (528/546) during the last 2 years of experience. The accuracy rate for fetal male gender identification increased from 91.7% during the first 2 years of TVS experience to 99.7% during the last 2 years of TVS experience, and the accuracy rate for female gender identification, increased from 93.3% to 100%, respectively, applying the above criteria and based on acquired experience of early fetal sex identification by TVS early in gestation. Early and precise determination of fetal sex is possible and might avoid invasive procedures such as amniocentesis.

Female↗
PubMed1990

Transvaginal sonographic diagnosis of congenital anomalies between 9 weeks and 16 weeks, menstrual age.

A 6.5-MHz transvaginal probe was employed for the screening of congenital malformations in 1652 patients between 9 weeks and 16 weeks, menstrual age. Transvaginal sonography detected 61 malformations in 40 fetuses. The overall diagnostic frequency of the congenital anomalies in this series was 2.6%. As described in this study, several congenital malformations are now detectable before the 16th week, and transvaginal sonography appears to be the diagnostic method of choice for the first and early second trimester.

Congenital Abnormalities↗
PubMed1990

Classification of ovarian lesions by high-frequency transvaginal sonography.

Two hundred patients suspected of having ovarian pathology were scanned with a 6.5-MHz transvaginal probe. Normal anatomical structures and abnormal findings were recorded and classified according to their shape, size, location, and sonographic characteristics. The sonographic images were correlated with the surgical findings, whenever available. A sonographic classification of ovarian lesions was compiled according to the presence or absence of the following sonographic components: septae, papillae, loculations, daughter cysts, solid mass, or fluid, and their relationship to malignancy.

Female↗
PubMed1990

First and early second-trimester diagnosis of fetal urinary tract anomalies using transvaginal sonography.

Urinary tract anomalies are common. Prenatal diagnosis is important and enables either special obstetric management or termination of pregnancy and probably in the future, intrauterine intervention. Transvaginal sonography (TVS) allows visualization of the normal and anomalous fetal urinary tract at an early stage. One thousand nine hundred and forty women were examined via TVS at an early stage of pregnancy between 10 and 16 weeks from the last menstrual period (LMP) and 35 anomalies (1.8 per cent) were clearly identified: 29 cases of low urinary tract obstruction, 2 cases of multicystic dysplastic kidney, 2 cases of polycystic kidney (infantile type), 1 case of double collecting system, and 1 case of horseshoe kidney. Potter syndrome could be ruled out in three patients who had delivered fetuses suffering from this anomaly in previous pregnancies. The concise and early identification of anomalies makes TVS an important aid in the hands of the obstetrician, ultrasonographer, and neonatologist.

Abnormalities, Multiple↗
PubMed1990

Prenatal diagnosis of ventricular septal defect and overriding aorta at 14 weeks' gestation, using transvaginal sonography.

Two fetuses with heart abnormalities were detected by transvaginal sonography at 14 weeks of gestation. In the first fetus, a ventricular septal defect and an overriding aorta were detected and a diagnosis of tetralogy of Fallot was suggested. In addition, cystic hygroma and omphalocoele were visualized and the cytogenetic study revealed trisomy 18. In the second fetus, ventricular septal defect, pericardial effusion, and omphalocoele were detected.

Adult↗
PubMed1989

von Willebrand factor multimer patterns in pregnancy-induced hypertension.

Microangiopathy and disseminated platelet aggregation have been reported in thrombotic thrombocytopenic purpura (TTP) and pregnancy-induced hypertension (PIH). Since unusually large von Willebrand factor (vWF) multimers have been implicated in the evolvement of TTP, we analyzed factor VIII/vWF parameters in patients with PIH. Mean vWF: Ag level was significantly higher in 27 patients with PIH as compared to 20 matched healthy pregnant women (358 +/- 160 u/dl vs. 274 +/- 125 u/dl. p less than 0.05). Moreover, plasma vWF: Ag levels and the ratio of vWF: Ag to factor VIII were found to be linearly correlated to the severity of PIH. In contrast, no significant differences in mean levels of factor VIII and ristocetin cofactor were observed between these groups. Crossed immunoelectrophoresis of vWF revealed a higher incidence of a pre-peak and an increased migration index in the PIH group as compared to the control group (60% vs. 44% and 1.27 +/- 0.26 vs. 1.19 +/- 0.18, p less than 0.01 respectively). Analysis of plasma vWF multimer patterns by 1.4% agarose electrophoresis in 0.1% SDS revealed excessive amounts of large, medium and small size multimers in the PIH patients. Conceivably, the quantitative changes in vWF multimers reflect endothelial injury and may play a role in the microangiopathy observed in PIH.

Adult↗