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Biomedical subjects

M C Treadwell

Publications and source records attributed to M C Treadwell.

40 records · Page 3Linked to original sources

Comparison of intrapartum fetal monitor tracings of karyotypically abnormal and control infants.

To determine if there are any specific monitoring patterns associated with chromosomal abnormalities the intrapartum tracings of 17 postnatally diagnosed karyotypically abnormal infants were obtained. Controls were randomly selected from infants born on the same day at the same gestational age. The tracings from these two groups were independently evaluated. Comparison of the monitor interpretations showed: (1) the karyotypically abnormal group was more likely to have decreased or absent short- (p < 0.001) and long-term (p < 0.01) variability; (2) accelerations were more likely to be represented in the control group (p < 0.001); (3) no significant differences were found in the baseline heart rates or in the presence or frequency of mild, moderate, or severe variable or late decelerations. These findings may reflect underlying central nervous system abnormalities as opposed to uteroplacental insufficiency, but are not specific to karyotypically abnormal infants.

Chromosome Aberrations↗

Sonographic screening for trisomy 21: fetal humerus:foot length ratio, a useful new marker.

We have analyzed morphometric measurements from midgestational fetal necropsies and shown that arm and foot lengths are linear relationships versus gestational age (GA). Using foot length as the GA determinant, we found that the ratio of arm:foot length was also a linear relationship and was decreased in trisomy 21 fetuses when compared to age-matched normals. Based on these laboratory findings, we prospectively evaluated the use of the humerus:foot length ratio as a sonographic screening tool for identification of fetuses at risk for trisomy 21. Humerus length, foot length and the humerus:foot length ratio were found to be linear relationships vs. gestational age in both the normal and trisomy 21 populations. However, the regressions for the humerus:foot length ratio were significantly different between normals and Down's fetuses (p < 0.001). We found that a humerus:foot length ratio < or = 0.85 correctly identified 47% of our trisomy 21 fetuses (spec = 0.92, PPV = 0.25, NPV = 0.97). When compared to women > or = 35 years old in our high risk population, a humerus:foot length ratio < or = 0.85 carried an odds ratio of 52.7 (99% CL = 9.72-285.23) for trisomy 21.

Adult↗

Differences in measurements of the atria of the lateral ventricle: does gender matter?

OBJECTIVE: To evaluate possible differences in measurements of the width of atria of the lateral cerebral ventricles of male and female fetuses. STUDY DESIGN: A prospectively entered database was reviewed to identify patients undergoing ultrasound examination at > 13 weeks between July 1, 1994 and June 30, 1995. Inclusion criteria included identification of fetal gender, measurement of the atria, and the absence of fetal anomalies. RESULTS: The atrial width of the lateral ventricles was statistically greater in male than in female fetuses (7.1 vs. 7.0 mm, p < 0.001). CONCLUSION: Although statistically significant, the difference between genders in the measurement of the ventricular atria is too small to be of clinical utility.

Cerebral Ventricles↗

Prenatal sonographic diagnosis of clubfoot: implications for patient counseling.

This study was undertaken to determine the incidence of prenatally, sonographically diagnosed clubfoot; the incidence of associated anomalies; and the correlation with postnatal findings. Cases of prenatally diagnosed clubfeet were abstracted from a prospectively entered ultrasound database. Scans were reviewed for the presence of associated anomalies. Available neonatal charts were reviewed for correlation with prenatal findings. The incidence of prenatally diagnosed clubfoot was 0.43%. This was isolated in 33% of the cases and associated with other anomalies in 67%. All cases with associated anomalies were identified prenatally. There was a 40% false-positive rate for isolated clubfoot, all diagnosed in the third trimester of pregnancy. Prenatally diagnosed clubfoot was seen in 0.43% of this high-risk population. The correct identification of associated anomalies facilitates prenatal counseling, but limitations of prenatal ultrasound must be remembered. This information should be helpful to orthopaedic surgeons involved in the counseling of these patients.

Abnormalities, Multiple↗