Biomedical subjects
Publications and source records attributed to M Mazor.
An unusual case of a 31 year-old Bedouin women, with secondary infertility of 13 years' duration who conceived twice spontaneously after removal of a hydatic cyst from her frontal lobe is reported. The reproductive function was restored probably by releasing the hypothalamic-pituitary axis from the pressure exerted by the cyst.
A case of twin pregnancy complicated by intra-uterine death of one fetus 10 weeks before term is described. The occurrence of this complication raises difficult questions about the management and outcome of this rare event. A review of 23 patients with similar findings brought us to the conclusion that the management protocol to be applied should be based, if possible, on the type of placentation.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Pregnant women feel movements from about the fifth month of pregnancy. In cases of high-risk pregnancy daily recording of fetal movements is useful in monitoring fetal well-being. Complete cessation of fetal movements points to a severely distressed fetus and impending death. We report here five women in whom failure to experience fetal movements was present from the beginning of pregnancy, or occurred after fetal movements had been felt for several weeks during the pregnancy. All the women delivered normal infants with high Apgar score.
Over a period of one year 312 high-risk patients (HRP) were prospectively monitored using ultrasound score (USS), nonstress test (NST) and contraction stress test (CST). There were nine cases with low USS, seven of them had reactive NSTs, were delivered vaginally without any evidence of distress in labour and had normal Apgar scores with no perinatal morbidity. In the remaining two cases the NST was nonreactive and they were delivered by cesarean section because of fetal distress. The NST was not reactive in 18 patients, eight of them subsequently had abnormal CST and displayed fetal distress during labour. The USS was high in 16 cases. The results of this study seems to indicate that in cases with nonreactive NST, CST is a better predictor of fetal outcome than the ultrasound score.
Among 1,411 breech deliveries at the Soroka Medical Center, Beer-Sheva, Israel, there were 116 cases of congenital anomalies (8.2 %). Forty-nine fetuses (3.47%) exhibited major congenital anomalies and 67 (4.7%), minor ones. The incidence of chromosomal anomalies was 0.63% (1 per 159 births) as compared with 0.25% in the general population. The frequency distribution indicated that most of the fetuses with congenital abnormalities weighed 2,000 gm or more. In view of the high incidence of chromosomal aberrations and major congenital anomalies among fetuses with breech presentation, it seems desirable to consider ultrasonographic assessment and chromosomal analysis during the last trimester of pregnancy.
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Necrotizing fasciitis is a rare disease with a high mortality and morbidity rate. The authors report the case of a 52 year old woman with necrotizing fasciitis following abdominal hysterectomy. The early diagnosis and the radical surgery saved her life from this serious type of infection. By describing this case, the authors wish to emphasize their opinion that early diagnosis is essential to survival and the most important aspect of management is early aggressive surgical intervention.
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Modern diagnostic methods reveal an increased number of cases of gross fetal malformations, and physicians are faced with serious ethical considerations. The disclosure of data during conversations with the parents, the decision-making process and the different courses of action are discussed. Cases with defined diagnoses may be divided into three different clinical situations: 1) a malformation incompatible with extrauterine life; 2) increasing organ damage caused by a fetal defect; and 3) a severely handicapped fetus capable of short- or long-term survival. The recent concept of fetal abuse is emphasized. When pregnancy is allowed to continue to term in these cases, psychological and social aspects must be taken into consideration. Medical assessment, ethicolegal norms, and religious beliefs of parents and physicians should guide the course of action. We believe that the medical team should perform late termination of pregnancy when justified and approved by a court or a statutory committee.
The significance of single sporadic deceleration occurring during antepartum fetal heart rate monitoring was assessed. Single sporadic deceleration was defined as a drop of fetal heart rate of at least 40 bpm below baseline lasting for at least 2 min. During the year 1980, 7202 nonstress tests (NST) were performed in pregnant patients, with gestational ages ranging from 32-42 wk. Among these, 62 cases of single sporadic deceleration were observed. In 48 of these cases the single sporadic deceleration was followed by a normal reactive NST. In 14 patients NST following the single sporadic deceleration was non-reactive. In those cases oxytocin challenge test (OCT) was performed and was negative in 10 and positive in 4 cases. In the latter 4 patients labor was induced and all required cesarean section because of severe fetal distress. The remaining 58 women were followed up at the High-Risk Pregnancy Unit until spontaneous labor began, their deliveries were monitored throughout. In 8 cases out of the 58, fetal distress was observed during labor and in 4 of them cesarean section was required. The occurrence of single sporadic deceleration at gestational ages 32-42 wk is not an alarming sign providing the NST and/or O.C.T. are normal. However, the incidence of fetal distress during labor is significantly higher in fetuses with single sporadic deceleration as compared to the normal parturient population.
Platelet MAO activity was affected by preincubation with cannabinoid derivatives in vitro. The psycho-active derivative delta 1-THC inhibited MAO activity in platelets to an extent varying according to its concentration while CBD and (+) delta 6-THC had no inhibitory effect. (-) delta 6-THC, which is minor psychomimetic component, had less inhibitory effect on MAO activity than delta 1-THC. However, (-) DMH delta 6-THC revealed no attenuation effect on MAO inspite of its well-known psychomimetic activity.
We report an unusual case of a poorly differentiated signet ring cell type of adenocarcinoma of the cecum, rare in its own right, that had metastasized to the endometrium. The diagnosis was made on the basis of fractional uterine curettage. It is believed that this is the first case of such an unusual cecal carcinoma metastatic to the endometrium.
Repeated samplings of scalp blood pH were obtained from 62 fetuses in whom continuous fetal heart rate monitoring was indicative of fetal distress. In all, 182 scalp blood samples were evaluated. Umbilical cord blood pH was determined immediately after delivery in 48 cases. In addition to heart rate abnormalities, fetal metabolic changes were considered in determining the mode of delivery. Vaginal delivery was allowed in 74.2% of the patient in our series and only 25.8% had cesarean sections. Repeated scalp blood pH sampling proved to be an important adjunct to continuous fetal heart rate monitoring in increasing the accuracy of diagnosis of fetal distress.
There is an ethical and legal problem for obstetricians when a pregnant patient, before or during labor, is notified by her physician that the fetus is in danger of dying and in need of surgical intervention, and she does not accept this advice. Such a case may occur for various reasons. This report attempts to address the issue of the fetus' right to life and the legal aspects thereof according to the laws of different countries. We accept the fact that the fetus has a legal right to live and the parents are the natural guardians. If the child is capable of being born alive and the patient does not consent to being subjected to a given treatment directed to save the fetus, the doctor must be legally entitled to warn the patient that she is committing a felony.