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Biomedical subjects

M Glezerman

Publications and source records attributed to M Glezerman.

At least 91 records · Page 5Linked to original sources
PubMed1995

Antibodies to Ureaplasma urealyticum in women with intraamniotic infection and adverse pregnancy outcome.

OBJECTIVE: To determine the association between antibody response to Ureaplasma urealyticum and pregnancy outcome in women with ureaplasmal invasion of the amniotic cavity. METHODS: A cross section study was performed in our high risk pregnancy unit. Three groups of pregnant women were identified: 1) 271 women at the midtrimester of pregnancy (16-20 weeks), who underwent transabdominal amniocentesis for genetic indications 2) 161 consecutive women admitted with preterm labor and intact membranes. 3) 118 consecutive patients with preterm premature rupture of membranes. Amniotic fluids were cultured for Ureaplasma urealyticum, Mycoplasma hominis and also for other aerobic and anaerobic bacteria. Serum antibodies to Uu were measured by a specific enzyme-linked-immunosorbent-assay. RESULTS: The prevalence of positive AF cultures with Uu in the 3 study groups was 2.9%, 4.3% and 17.8%, and the prevalence of antibodies to Uu in the AF-colonized patients was 50%, 86% and 57%, respectively. Adverse pregnancy outcome (preterm birth, low birth weight or fetal death) among all AF colonized women, was significantly higher in patients with antibodies to Uu than in those without antibodies; preterm delivery 90% vs. 43%, and low birth weight infants or fetal death 85% vs. 28%, p = 0.006 and 0.001 respectively. CONCLUSION: Women with intraamniotic infection with Uu and elevated levels of antibodies to Uu, had a higher rate of preterm delivery, and low birthweight infants/fetal death than those without antibody to Uu.

Adult↗
PubMed1995

The diagnostic value of amniotic fluid Gram stain examination and limulus amebocyte lysate assay in patients with preterm birth.

The purpose of this study was to determine the value of Gram stain examination and Limulus amebocyte lysate (LAL) test in the detection of intraamniotic infection. Ninety women with preterm labor and intact membranes (n = 55) or preterm premature rupture of membranes (PROM) (n = 35) who delivered prematurely were included in the study. Amniotic fluid was cultured for aerobic and anaerobic bacteria as well as for mycoplasmas. Amniotic fluid analysis included Gram stain examination and limulus amebocyte lysate tests. The prevalence of positive amniotic culture was 32.2% (29/90) and the most common isolate was Ureaplasma urealyticum. Patients with preterm PROM group had a higher rate of infection than those with preterm labor and intact membranes 57.1% (20/35) vs. 16.4% (9/55), respectively (p = 0.0001). We found a lower gestational age at delivery and lower mean birth weight in neonates born to mothers with a positive amniotic fluid culture than those with negative amniotic fluid culture. The combined use of Gram stain examination and LAL test had a sensitivity and specificity of 51.7% (15/29) and 95.1% (58/61) respectively for the detection of positive amniotic fluid culture. We conclude that Gram stain examination and LAL test are rapid, simple and specific tests that can be used to detect microbial invasion of the amniotic cavity except in patients with mycoplasmas infections.

Adult↗
PubMed1995

Infection of the amniotic cavity with Ureaplasma urealyticum in the midtrimester of pregnancy.

The purpose of this study was to determine the clinical significance of invasion of the amniotic fluid (AF) with Ureaplasma urealyticum in the midtrimester of pregnancy. Amniotic fluid and cervical swabs obtained from 214 asymptomatic women in the midtrimester of pregnancy (16-20 weeks) were cultured for U urealyticum and Mycoplasma hominis. Inoculum size was determined by quantitative culture. Six of the 214 women (2.8%) had Ureaplasma in high titers in the AF. The pregnancy outcomes of 129 women were determined. Adverse pregnancy outcome occurred more frequently in women with a positive AF culture than in women with a negative AF culture (3/6 [50%] vs. 15/123 [12%], respectively; P = .035). We conclude that infection of the amniotic cavity with U urealyticum can be present in asymptomatic patients in the midtrimester of pregnancy and is a significant risk factor for spontaneous preterm labor and delivery. These observations suggest that routine culture of AF at the time of midtrimester amniocentesis can identify the group of patients at risk for a poor pregnancy outcome.

Abortion, Spontaneous↗
PubMed1995

Dose intensity of cisplatin-based chemotherapy in epithelial ovarian carcinoma. An important factor affecting survival.

Forty-three patients with epithelial ovarian carcinoma, were treated by cyclophosphamide and cisplatin (CP) following initial laparotomy. The mean dose intensity (DI) and mean relative dose intensity (RDI) respectively were for cyclophosphamide: 166.69 mg/sqm/week and 0.67, and for cisplatin: 16.29 mg/sqm/week and 0.65. The mean average relative dose intensity (ARDI) was 0.66. The three-year survival for all patients was 44.3%. The three-year survival for patients receiving cyclophosphamide with a RDI of more than median value was 63.82%, while for patients receiving cyclophosphamide with a RDI of less than median value three-year survival was 26.3% (p < 0.02). The three-year survival for patients receiving cisplatin with an RDI of more than median value was 62.01%, as compared to 24.17% for patients receiving cisplatin with a RDI of less than median value (p < 0.02). The three-year survival for patients receiving the CP regimen with an ARDI of more than median value was significantly higher than that for patients receiving the CP regimen with an ARDI of less than median value (63.82% versus 26.03%, p < 0.02). Dose intensity of cisplatin-based chemotherapy in epithelial ovarian carcinoma is an important factor affecting survival.

Adult↗
PubMed1995

Eradication of viridans streptococci from the amniotic cavity by parenteral antibiotic administration. A case report.

BACKGROUND: A growing body of evidence suggests that infection plays a key role in the pathogenesis of preterm labor and delivery. Recently, localized intrauterine infection was recognized as a major factor in preterm labor. CASE: We report a case of successful eradication of Viridans streptococci from the amniotic cavity in a patient with preterm labor and intact membranes at 30.5 weeks of gestation by parenteral administration of antibiotics. Following this treatment, preterm labor was arrested, and pregnancy prolonged until term delivery. CONCLUSION: Parenteral antibiotic treatment may be seriously considered for select patients presenting with preterm labor associated with microbial invasion of the amniotic cavity.

Adult↗
PubMed1994

Granulosa cell tumor of the ovary: a study of 18 cases.

In a study of 18 patients diagnosed with ovarian granulosa cell tumor between 1961 and 1992, clinical and pathologic findings were evaluated. Of the 18 patients, 15 (83.3%) were diagnosed in Stage I and three (16.7%) in Stage III or IV. Six patients (33.3%) underwent conservative surgery and in 12 (66.7%) total abdominal hysterectomy and bilateral salpingo-oophorectomy was performed. At follow-up three patients (16.6%) had died of disease, three, 16 and 288 months, respectively, after initial surgery. The actuarial 5-year survival rate for Stage I was 100%, while that for Stages III and IV combined was 33.3% (P < 0.05). It is concluded that for patients with Stage IA, unilateral oophorectomy seems to be adequate treatment and for those with more than Stage IA, surgery should include total abdominal hysterectomy and bilateral salpingo-oophorectomy. Postoperative adjuvant chemotherapy is advocated for patients in whom spread of tumor beyond the ovaries has occurred.

Adolescent↗
PubMed1994

Perinatal outcome of triplet pregnancies following assisted reproduction.

PURPOSE: This collaborative work was undertaken to assess perinatal outcome of in vivo conceived triplets to those following in vitro fertilization and assisted reproductive technologies (ART). METHODS: 151 triplets were examined; 56 delivered following ART, 55 following ovulation induction by gonadotropins (GN), 27 following clomiphene citrate (CC), and 13 conceived spontaneously. RESULTS: Mean gestational length of triplets following ART (33.2 wks) was not different from those conceived following GN (33.4 wks) or CC (34.2 wks), but was significantly shorter compared to triplets following spontaneous conception (35.3 wks). Mean fetal birthweight following ART (1743 g) did not differ significantly from that following GN (1683 g) or CC (1863 g) but was significantly lower compared to those delivered after spontaneous conception (1963 g). Although no difference was found in the incidence of low birthweight infants between the groups studied, the incidence of very low birthweight newborns (<1500 g) following ART or GN was significantly higher than following spontaneous conceptions (30.6%, 30.3% vs 10.3%). Differences in perinatal mortality were not significantly different between the groups examined (77.9, 60.6, 111.0, 25.6/1000 for ART, GN, CC, and spontaneous conceptions respectively). CONCLUSION: In conclusion, a similar perinatal outcome was shown for triplets conceived following ART and those following ovulation induction by GN, suggesting that the in vitro conditions as such were not the main contributing factor influencing the clinical outcome but rather the GN treatment. Triplets conceived spontaneously have a better outcome compared to those following ovulation induction or ART in terms of gestational length and birthweight.

Birth Weight↗
PubMed1994

Human preterm birth is associated with systemic and local changes in progesterone/17 beta-estradiol ratios.

OBJECTIVE: The purpose of this study was to determine whether human preterm birth is associated with changes in 17 beta-estradiol and progesterone concentrations in maternal plasma and amniotic fluid. STUDY DESIGN: Forty healthy women in preterm labor with singleton pregnancies and intact membranes at 32 to 36 weeks of gestation who underwent amniocentesis for evaluation of the microbiologic status of the amniotic cavity were classified into the following two groups: 20 women who were delivered within 1 week from the amniocentesis (preterm delivery group) and 20 who were delivered at term (term delivery group). Maternal plasma and amniotic fluid concentrations of progesterone and 17 beta-estradiol were measured with sensitive and specific commercially available radioimmunoassay kits. RESULTS: The median amniotic fluid concentration of 17 beta-estradiol was significantly higher in women delivered prematurely than in those who were delivered at term (1.5 ng/ml vs 0.9 ng/ml, p = 0.0001). Moreover, the median plasma 17 beta-estradiol concentration was also significantly higher in the preterm delivery group than in the term group (14.1 ng/ml vs 6.9 ng/ml, p = 0.022). In contrast, no significant difference was found in amniotic fluid and plasma concentrations of progesterone between these two groups (24.5 ng/ml vs 27.5 ng/ml and 132.0 ng/ml vs 107.5 ng/ml, respectively). The median amniotic fluid progesterone/17 beta-estradiol ratio was significantly lower in the preterm delivery group than in those delivered at term (18.4 vs 33.6, respectively, p = 0.0017). Moreover, the median plasma progesterone/17 beta-estradiol ratio was also significantly lower in the preterm delivery group than in the term group (9.8 vs 17.0, respectively, p = 0.016). CONCLUSION: Human preterm birth is associated with significantly lower progesterone/17 beta-estradiol ratios than those of women with preterm labor delivered at term.

Adult↗
PubMed1994

The significance of serum progesterone levels on the day of hCG administration on IVF pregnancy rates.

The aim of the present study was to evaluate the relationship between serum progesterone level on the day of human chorionic gonadotropin (hCG) administration (day 0) and pregnancy rate among patients undergoing in vitro fertilization and embryo transfer. Serum progesterone levels were analyzed retrospectively in 160 cycles. In 56 women ovarian stimulation was induced by gonadotropins only (group A). In 104 cases a gonadotropin releasing hormone (GnRH) analog was given prior to gonadotropin administration (group B). At least three embryos were transferred in all cases. A significantly (p < 0.01) higher serum progesterone level (> or = 1 ng/ml) on day 0 was observed in the 43 patients of group A who did not conceive compared with the 13 who conceived. No significant difference in serum progesterone levels on day 0 was found between the 37 patients of group B who conceived and the 67 who did not. The pregnancy rate (0.36) in group B was significantly (p < 0.05) higher than that in group A (0.23). However, the pregnancy rate (0.35) in patients in group A with low progesterone levels (< or = 1 ng/ml) was not significantly lower than that in group B. We demonstrated that elevated progesterone levels (> or = 1 ng/ml) on day 0 in patients receiving stimulation with gonadotropin only, might be detrimental to pregnancy. In view of these results, we suggest that early oocyte retrieval should be considered in patients whose progesterone level on the day of hCG administration exceeds 1 ng/ml following stimulation with gonadotropin only.

Adult↗
PubMed1994

Association between preterm birth and increased maternal plasma cortisol concentrations.

OBJECTIVE: To measure the amniotic fluid (AF) and plasma concentrations of cortisol in women with preterm labor and intact membranes. METHODS: Thirty-eight normal healthy women with singleton gestations, preterm labor, and intact membranes at 32-36 weeks' gestation underwent amniocentesis for evaluation of the microbiologic status of the amniotic cavity. Nineteen women delivered within 1 week of amniocentesis (preterm labor and delivery group), and 19 delivered at term (preterm labor and term delivery group). Maternal plasma and AF concentrations of cortisol were measured with sensitive and specific, commercially available radioimmunoassay kits. RESULTS: The median plasma cortisol concentration was significantly higher in women who delivered prematurely than in those who delivered at term (260 versus 240 ng/mL; P = .014). However, no significant differences in median AF cortisol concentrations were detected between the groups (13 versus 14 ng/mL). CONCLUSIONS: Although maternal plasma cortisol concentrations were significantly higher in women with preterm birth, no similar changes were found in the AF. The rise in maternal plasma cortisol may be related to the stress mechanism of labor.

Adult↗
PubMed1994

Premature delivery of small versus appropriate-for-gestational-age neonates. A comparative study of maternal characteristics.

Prematurity and growth retardation of the fetus are major factors affecting perinatal outcome. The purpose of this study was to compare maternal characteristics of 63 women who delivered a preterm, small-for-gestational-age (SGA) neonate with those of 63 women matched for parity and gestational age who delivered a preterm, appropriate-for-gestational-age (AGA) neonate. All women delivered at the Soroka Medical Center between January 1, 1985, and December 31, 1990. Mothers of SGA neonates were more likely than those of AGA neonates to be over the age of 35 years (P = .043), to have hypertensive disorders and oligohydramnios (P < .001), to have induced labor (P < .001) and to deliver by cesarean section (P < .001). In addition, they had a higher rate of morbidity in the puerperium (P = .015) and were more likely to have longer hospitalization (P = .002). In contrast, previous preterm deliveries were significantly more common in the AGA group than in the SGA group (P = .034). The results of this study indicate that women who deliver preterm SGA neonates belong to a special subgroup with unique characteristics in comparison to those who deliver preterm AGA neonates.

Adolescent↗
PubMed1993

[Early ultrasonic diagnosis of conjoined twins].

Conjoined twins is a rare congenital malformation occurring in 1:30,000-1:100,000 live births. Its early prenatal detection was extremely rare prior to the introduction of obstetric ultrasonography. We report 3 cases of early ultrasound diagnosis of conjoined twins at 9, 15 and 19 weeks of pregnancy, respectively. The diagnosis at 9 weeks of gestation was made via the transvaginal approach, and to the best of our knowledge is the earliest diagnosis reported in the English literature. In all 3 cases the fetuses were of the thoraco-omphalopagus type and had a shared heart. Pregnancy was discontinued in all 3 cases using methods appropriate for the first and second trimesters of pregnancy.

Abortion, Therapeutic↗
PubMed1993

Maternal mortality in southern Israel.

Between 1969 and 1991 there were 166,410 births in Southern Israel with 13 maternal deaths (7.8/100,000). In the Jewish population there were 119,130 deliveries with 7 maternal deaths (5.9/100,000), and the Bedouins had 47,280 deliveries with 6 maternal deaths (12.7/100,000). Prenatal care was an important preventive factor. 7 maternal deaths occurred among 151,088 women who had received prenatal care (4.6/100,000), whereas 6 such deaths occurred among 15,322 without prenatal care (39.1/100,000) (P value 0.0005). Ten of the 13 women who died were over 24 years old. Eight of the 13 patients were multiparous. Live births occurred in 6 patients and stillbirths in 5 patients. Hemorrhage, preeclampsia-eclampsia and pulmonary embolism were the leading causes of maternal death.

Cross-Cultural Comparison↗
PubMed1993

Successful treatment of preterm labour by eradication of Ureaplasma urealyticum with erythromycin.

Ureaplasma urealyticum was detected in the amniotic cavity of a woman with premature contractions at 32 weeks of pregnancy. Treatment with Erythromycin base was instituted for a period of ten days. Amniotic fluid analysis performed 48 hours after discontinuation of antibiotic treatment revealed sterile amniotic fluid. The pregnancy continued uneventfully until 39 weeks.

Administration, Oral↗