Biomedical subjects
Publications and source records attributed to M Mantoni.
A case of monoamniotic twins was diagnosed by ultrasonic scanning in the first trimester through the presence of two fetuses in one gestation sac. The fetuses died in utero in weeks 17 and 25. The possible ultrasound appearance of the various types of monozygotic and of dizygotic twins in early pregnancy is discussed and a scheme is suggested which allows some differentiation.
Ultrasound scanning in early pregnancy sometimes reveals a 2-5 mm spheric structure lying adjacent to the fetus. The occurrence of this structure was studied in 60 consecutive ultrasound examinations. In the 7th to 9th weeks the sphere was seen in 19 of 22 examinations, and in the 10th and 11th weeks it was seen in 10 of 20 examinations. The sphere was not demonstrated in any of 18 examinations in the 12th to 14th weeks. It is believed that the spheric structure is the yolk sac.
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The coagulation factors PP% (Factors II+IV), factor IX and factor X were determined in infants born by mothers receiving anticoagulants. The factors were very low when the mothers did not receive vitamin K before the delivery. No significant improvement in the factors was observed after an intravenous or intraamniotic injection of vitamin K two to four days before the delivery. Vitamin K was injected intramuscularly into four foetuses in utero using an ultrasonic multitransducer scanner. Three of these infants had normal coagulation factors at birth. In the fourth case the factor X was normal and factor IX was significantly better than in the infants of the other groups. The injection had no harmful effects to the infants.
In a prospective study 90 patients with clinically suggested lower limb deep venous thrombosis (DVT) were examined with duplex ultrasonography (US) prior to venography. No attempts were made to examine the calf veins. Five ultrasound examinations were inconclusive. Thirty-four patients had DVT diagnosed at US with a sensitivity of 97 per cent and a specificity of 96 per cent. Compressibility of the vein as assessed by the real-time image was in the acute phase an easy and fast test for DVT, whereas the Doppler data failed to add to the diagnostic accuracy. Twenty-seven patients with DVT were followed during anticoagulant treatment, but only 16 regained fully compressible veins within the observation period of 3 to 6 months. Duplex sonography was useful in monitoring the changes in vein patency during anticoagulant treatment.