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M Entezami

Publications and source records attributed to M Entezami.

At least 37 records · Page 2Linked to original sources
PubMed1997

[Accuracy of ultrasound weight assessment--comparison of vertex vs. breech presentation].

AIM: To determine the quality of prenatal sonographic weight estimation, comparing breech and vertex presentations. METHOD: In 147 breech presentations (BP) and 149 vertex presentations (VP), the biparietal head diameter (BPD), the fronto-occipital head diameter (FOD) and the transverse abdominal diameter (ATD) were measured. From these data, the weight was estimated, using Shepard's formula before 28 weeks and Hansmann's thereafter, and compared to the delivery weight. Both formula were modified to incorporate the virtual BPD (vBPD), derived from the BPD, FOD and the calculated head circumference. In the BP group, the role of examiner skills was evaluated, comparing the accuracy of experienced (DEGUM II qualifications) and average individuals. RESULTS: The accuracy for BP was nearly identical to that for VP (= 0.915 vs. = 0.929). The examiners' qualifications had a detectable but not significant influence on the results (= 0.942 vs. = 0.892). CONCLUSION: Ultrasound measurements yield comparable results in both BP and VP, if the vBPD is used. In our opinion, ultrasonic weight estimation is a useful adjunct when determining the manner of delivery in BP.

Birth Weight↗
PubMed1997

Combined partial trisomy 3p/monosomy 5p resulting in sonographic abnormalities.

We report here a case of partial trisomy of the short arm of chromosome 3 combined with partial monosomy 5p due to malsegregation of a balanced maternal translocation t(3;5). The newborn demonstrated esophageal atresia and complex cerebral malformations. Conspicuous sonographic findings offering the chance of prenatal detection included polyhydramnios without visualization of the stomach, as well as a single umbilical artery. The child died 8 days postpartum.

Abnormalities, Multiple↗
PubMed1997

Knowledge-based system ADNEXPERT to assist the sonographic diagnosis of adnexal tumors.

ADNEXPERT is a knowledge-based system for the computer-assisted ultrasound diagnosis of adnexal tumors. In a case-based approach, ADNEXPERT used histopathologic and sonographic data from 2,290 adnexal tumors. After an ultrasound examination, the gynecologist interacts with the system. A maximum of 15 questions are posed; all but one question (age) relate to the sonographic findings. The help system gives online access to an ultrasound image library. Once the dialogue is complete, ADNEXPERT assesses the adnexal tumor pathology and makes a histological classification. A certainty factor (CF) model is used for knowledge representation. The CFs of the knowledge base are computed from the case database. During system evaluation, the accuracy of ADNEXPERT was tested by 69 new adnexal tumor cases, for which verified histopathological diagnoses were available. ADNEXPERT accurately assessed pathology in 49 cases (71%); in 10 cases (14%) correct indications to pathology were given; no diagnostic hints were attained in 2 cases (3%); and 8 cases (12%) were falsely diagnosed. Based on the positive results of the evaluation, ADNEXPERT will be tested under clinical conditions.

Adolescent↗
PubMed1997

Intrauterine rhabdomyoma of the heart. A case report.

Primary cardiac tumors are rare findings in adults and children. A case is presented in which ultrasound examination revealed an incredibly large tumor in the heart of a fetus at 24 weeks. Tumor filled the whole left ventricle. Histology and immunohistochemistry were indicative of rhabdomyoma, i.e., a hamartoma that is often associated with tuberous sclerosis.

Actins↗
PubMed1996

Hepatocellular carcinoma as a rare cause of an excessive increase in alpha-fetoprotein during pregnancy.

A case report is presented on a hepatocellular carcinoma (HCC) during pregnancy, in which a massive increase in alpha-fetoprotein (AFP) was found during a routine screening for neural tube defects in the 17th week of pregnancy. The amniocentesis revealed a normal AFP level in the amniotic fluid. Liver sonography in the 21st week of pregnancy showed a 5-cm tumor, which was interpreted as nodular focal hyperplasia. In the control sonography in the 32nd week of pregnancy, there was growth to 12 cm. The subsequently performed magnetic resonance imaging and fine-needle aspiration led to the diagnosis of a HCC. Delivery was performed in the 34th week of pregnancy by cesarean section, and surgical therapy of the HCC followed.

Adult↗
PubMed1996

[Estrogenic effects after 14-days administration of 0.06 mg ethinyl estradiol in postmenopausal women].

The effect of a 26 day oestrogen-gestogene sequence therapy on double endometrium thickness, uterus size, blood flow in the uterine blood vessels (pulsatility and resistance index), serum concentration of FSH, LH and SHBG and on vaginal cytology of postmenopausal women was tested double-blind in a placebo-controlled trial. Thirteen postmenopausal women received 0.06 mg ethinyloestradiol (EE2) over 14 days and then a 12 day combination treatment with 0.04 mg EE2 and 0.125 mg levonorgestrel. Eight women received placebo treatment over 26 days. In each group, half the women were less, and half were more than 10 years postmenopausal. The above parameters were unchanged in the placebo group. However, in the verum group, the double endometrium thickness increased from 2 mm to about 6 mm after a 7 day treatment with EE2 and after a further treatment week with EE2, increased another millimeter. There was no obvious difference in the treatment groups between women less than ten years after menopause or more than ten years after menopause. Blood flow in the uterine artery increased significantly (decrease in pulsatility and resistance index by about 50%). Again, there did not seem to be any obvious connection with the menopausal interval. FSH decreased after the first treatment week by about 50% and 65% after the second treatment week. There was no significant decrease in LH. SHBG increased by about a factor of 5. An oestrogen effect could be demonstrated in the vaginal cytology of all cases in the verum group.

Aged↗
PubMed1995

[Acute torsion of hydrosalpinx. 2 cases after laparoscopic sterilization].

We report on two laparoscopically sterilised patients who presented with increasing lower abdominal pain and sonographically proven adnexal masses. The first patient, who had been sterilised two years ago, underwent primary laparotomy. The mass was found to correspond to the cystically altered distal part of the right sterilised tube being torquated twice. Standard salpingectomy was performed. On the second patient, sterilised ten years before presentation at our clinic, we performed laparoscopy because of the suspected diagnosis of a pyosalpinx. In this case we found a torsion of the ampullary part of the left tube, which was subsequently removed by laparoscopy.

Adult↗
PubMed1995

[Fetal macrosomy and hydramnios. Intrauterine symptoms of a combination of Sturge-Weber-Krabbe- and Klippel-Trenaunay syndrome].

The authors report on a case where the Klippel-Trenaunay symptom complex was combined with a Sturge-Weber-Krabbe syndrome, which, however, was only noticeable during pregnancy by fetal macrosomy and hydramnios. The child was delivered on term by Caesarean section and presented no paediatric problems; however, during the first few years of its life mental retardation became clearly evident.

Adult↗
PubMed1995

[Diagnostic reliability of vaginal ultrasound in ectopic pregnancy].

The therapeutic approach to ectopic pregnancy (EP) has changed over the last decade. A prerequisite for a differentiated management is an early diagnosis of EP. This can be achieved by transvaginal sonography (TVS). The purpose of this study was to evaluate the accuracy of TVS in the diagnosis of EP. 184 patients with clinically suspected ectopic pregnancy were examined by TVS. In 103 cases suspicion of EP was confirmed, in 81 cases it was ruled out. All cases were evaluated by laparoscopy, D&C, serial HCG determinations or sonographic follow-up in case of an intrauterine pregnancy. Sensitivity of TVS in the diagnosis of EP was 96%, specificity 88%, the positive predictive value was 89%, the negative predictive value was 95%. Four cases with a false negative result at TVS were very early in pregnancy and were subjected to laparoscopy because of persistent high HCG values without demonstration of an intrauterine pregnancy. Five cases of sonographically confirmed ectopic pregnancies were missed by the first laparoscopy. These cases required intervention because of clinical symptoms and had low levels of HCG. TVS has a high diagnostic accuracy in the diagnosis of ectopic pregnancy.

Adolescent↗
PubMed1995

[Prevention of neonatal risk by general screening for diabetes in pregnancy, intensive diagnosis and subsequent therapy].

Only 10% of all gestational diabetic mothers in Germany are diagnosed with the current risk-screening. The elevated perinatal risks in case of an unrecognized or insufficiently treated gestational diabetes remains controversial. The purpose of our study was to determine if the number of recognized cases could be increased by a general screening method, and with intensive medical diagnostics the complication rate reduced. Routine blood glucose samplings during the outpatient care were performed throughout the pregnancy. In case of values over 100 mg/dl a 75 g OGTT was done for an exclusion of gestational diabetes. In case of gestational diabetes the patients were asked to follow a special exercise and diet programme as well as self-blood glucose determinations throughout the day. The amniotic fluid insulin level was of substantial value for the indication of insulin therapy. In 6% of the screened patients a gestational diabetes was diagnosed. There was a significant increase (p < 0.001) of fetal macrosomia and diabetic fetopathy in the group without amniocentesis (n = 22) in comparison to the group with invasive (n = 81). We demand the introduction of a general screening for every pregnant patient. By an intensification of the diagnostic methods as well as by a strictly appropriate therapy it should be possible to reduce the fetal and neonatal complications.

Amniotic Fluid↗
PubMed1994

[Kinetocardiotocographic and Doppler ultrasound findings before termination of risk pregnancies].

42 pregnancies complicated by severe intrauterine growth retardation (IUGR) were monitored between 1991 and 1992 with the kinetocardiotocogram (K-CTG) comparing them with normal pregnancies of the same gestational age. We evaluated the foetal movements and the heart rate patterns establishing a correlation with pulsed Doppler ultrasound findings. There was a significant reduction of foetal activity in cases of IUGR and pathological Doppler sonography (p < 0.01). The reduction of foetal movements was noticed several days prior to pathological FHR patterns. There was a significant reactivity after vibroacoustical stimulation (VAS) correlating with the Doppler findings. The evaluation of foetal movement patterns in the kinetocardiotocogram proved to be an important complementary method in the monitoring of severe IUGR.

Abortion, Eugenic↗
PubMed1994

[Importance of measuring blood flow in monitoring pregnancy-induced hypertension and IUGR].

Doppler flow velocimetry of uterine and fetal vessels is carried out in high risk pregnancies. However, there is controversy about the predictive value of elevated resistance indices (RI) with respect of adverse fetal outcome. Therefore we estimated the frequency of elevated RI in uterine and fetal vessels in pregnant women with documented pregnancy induced hypertension (SIH, n = 9), intrauterine growth retardation (IUGR, n = 16) and uncomplicated pregnancies (n = 8). The results of the doppler flow velocimetry were compared to the fetal outcome. Elevated RI were observed in all vessels in the two groups with SIH and IUGR. In contrast, all RI in the control group were found to be in the normal range. The frequency of elevated RI in the a. uterine was slightly but not significantly higher in the SIH group than in the IUGR group. Approximately 50% of the infants of the groups with SIH and IUGR were born prematurely. However, in all but 4 infants apgar score and pH of cord blood were in the normal range. Decision for premature delivery in the IUGR group were mostly based on elevated RI. It is concluded that this may have led to delivery before fetal decompensation occurred and thus may have had a positive effect on fetal outcome.

Adult↗
PubMedDate not supplied

Feto-feto-fetal triplet transfusion syndrome (FFFTTS).

We report a case of feto-feto-fetal-transfusion-syndrome (FFFTS) in a spontaneous monochorionic triamniotic triplet pregnancy primarily diagnosed at 17 weeks of gestation. During the course of pregnancy, sequentially two triplets appeared as donor. Symptoms of a recipient (polyhydramnios, tricuspid valve insufficiency, and ascites) were present in the third triplet. The second of the donor twins died in utero at 25 weeks. At 27 weeks, a cesarean section was performed mainly due to pre-eclampsia. The first donor triplet developed normally, whereas the recipient showed periventricular leucomalacia and neurological impairment.

Cesarean Section↗
PubMedDate not supplied

[Femur-fibula-ulna (FFU) complex in the 33rd week of gestation: ultrasonography, radiology, pathology and differential diagnosis. Case report].

We present a case of a 27 year old I. gravida, I. para. Despite of regular ultrasonographic examination the diagnosis of skeletal malformation at the fetus was not before 33. weeks of gestation. It was the rare type of a bothside femur-fibula-ulna (FFU) complex. The FFU-complex is a no lethal malformation with typical unilateral combination from defects of femur and fibula, with contralateral defect of ulna. Dependent to involvement of malformated limbs the FFU-complex is classifiable in four groups. Only in 10 % all limbs are affected. Our case (type IV) showed a peromelia of both upper limbs with stumps of humeri, bothside aplasia of fibula and missing from 4. and 5. toes. There fetus were without nonlimb congenital abnormalities. The etiology of FFU-complex is unknown, the occurrence sporadic. There are never found genetic abnormalities. Familial recurrence is not described. There is no maternal or paternal age effect on FFU-complex. The differential diagnosis must include malformations with reduction anomalies of extremities, like thalidomide syndrome, splenogonadal fusion with limb malformations, Roberts syndrome, oroacral complex or acheiropodia. Mark off are amniotic band too.

Abnormalities, Multiple↗
PubMedDate not supplied

Prenatal diagnosis of a lethal multiple pterygium syndrome type II. Case report.

Advances in ultrasound technology and sonographer's experience lead to the description of many rare syndromes and malformations through prenatal diagnosis. Diaphragmatic hernia is a rather common malformation but can be an indicator of different syndromes. We report the prenatal diagnosis of lethal multiple pterygium syndrome type II which has been established in the 34th week of pregnancy. The sonographically detectable symptoms consisted of polyhydramnios, hygroma colli, diaphragmatic hernia, scoliosis, short forearms, hypokinesia of the fetus and pterygia over the large joints. Labour was induced in the 34th week of pregnancy; the neonate died shortly after vaginal delivery as a result of the pulmonary hypoplasia. A multidisciplinary approach in prenatal assessment may help to clarify difficult diagnostic problems and may be of direct benefit for the pregnant patient.

Abnormalities, Multiple↗
PubMedDate not supplied

Prenatal diagnosis of body stalk anomaly at 9 weeks of gestation. Case report.

We report on a case of embryonic anomaly detected at 9 + 5 gestational weeks. The lower part of the embryo was located in the coelomic cavity. Lower extremities could not be depicted. The abdominal wall showed the appearance of omphalocoele. After termination of pregnancy at 10 weeks, autopsy confirmed the anomaly of the lower embryonic parts consistent with the diagnosis of body stalk anomaly. To our knowledge, this is the first observation of this condition before 10 gestational weeks.

Abortion, Eugenic↗
PubMedDate not supplied

Mild ventriculomegaly, mild cerebellar hypoplasia and dysplastic choroid plexus as early prenatal signs of CHARGE association.

CHARGE association has been diagnosed postnatally in increasing numbers since the first description in 1979. The acronym CHARGE includes the abnormalities ocular Colobomas (iris, retina or nervus opticus), Heart disease, Atresia of choanae, Retarded growth and development and/or central nervous system anomalies, Genital hypoplasia, Ear anomalies and deafness. So far, no prenatal diagnosis of the CHARGE association has been described; only one case report presents prenatal symptoms detected at 31 gestational weeks. In our case, prenatally detected mild cerebral ventriculomegaly and dysplasia of choroid plexus were abnormalities visible as early as 15+6 weeks as well as mild cerebellar hypoplasia at 21+1 weeks. At 28+6 weeks, in addition polyhydramnios could be found. The combination of the 'benign' central-nervous findings raised suspicion of a severe congenital malformation at 21+1 weeks which was confirmed postnatally in the form of diagnosis of CHARGE association.

Adult↗