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N Vaisrub

Publications and source records attributed to N Vaisrub.

13 recordsLinked to original sources
PubMed1987

The human sex ratio: increase in first-born males to parents with shared HLA-DR antigens.

Maternal-fetal HLA-DR antigen sharing has been reported to affect the sex ratio of first-born. We therefore studied offspring sex ratios and birth orders in 66 families in which parents shared one or more HLA-DR antigens as compared to 61 families with no parental HLA-DR sharing. A significant excess of males was found among first-born children who were HLA-DR compatible with their mothers compared to first-born HLA-DR incompatible children of couples sharing HLA-DR antigens and couples not sharing HLA-DR antigens. Increased numbers of males may persist among children of higher birth orders in families where parents share both HLA-DR antigens, but not among couples sharing only one HLA-DR antigen. We hypothesize that the presence of the H-Y antigen in the male fetus may provide the necessary stimulus for a successful pregnancy in HLA-DR compatible pregnancies and may explain the excess of male births in the general population.

Birth Order↗
PubMed1986

Ultrasonic fetal abdominal circumference: comparison of direct versus calculated measurement.

The ultrasonically derived fetal abdominal circumference is one of the essential parameters used to predict birth weight, assess fetal growth, and follow the evolution of fetal ascites. Growth curves relating abdominal circumference to gestational age have been reported for directly measured abdominal circumferences. However, none have been reported for abdominal circumferences calculated from measurements of fetal abdominal diameters. In this report, 197 normal fetuses ranging from 18 to 41 weeks' gestation are studied. The validity of 468 abdominal circumferences calculated from fetal abdominal diameters is tested by comparing the data with a similar number of direct abdominal circumference measurements obtained by a digitizer. From 18 to 41 weeks' gestation, directly measured fetal abdominal circumferences are significantly larger than fetal abdominal circumferences calculated from abdominal diameters (P less than .0001). The authors conclude that clinical management decisions based on abdominal circumference data are predicated on the use of appropriate abdominal circumference and/or abdominal diameter growth curves.

Abdomen↗
PubMed1985

Real-time ultrasound estimations of weight in fetuses of diabetic gravid women.

To test the applicability of equations for fetal weight estimations in a group of fetuses suspected of being large for gestational age, real-time ultrasound measurements of fetal biparietal diameters and abdominal circumferences were obtained for 34 fetuses of diabetic mothers. In the first phase of the study the accuracy in the prediction of weight was assessed with use of two known equations. In the second phase, biparietal diameter, abdominal circumference, and actual birth weight data of the 34 study fetuses were used as independent variables to determine the best-fitting equation for relating estimated fetal weight (EFW) to biparietal diameter (BPD) and abdominal circumference (AC); this equation is log (EFW) = 0.02597 AC + 0.2161 BPD - 0.1999 (AC X BPD2)/1000 + 1.2659. The standard deviation of differences is 322.26 gm and multiple R = 0.781. In the final phase the reliability of this equation was compared to those of Thurnau and Shepard in 34 additional fetuses of diabetic gravid women. The data suggest that in these fetuses suspected of being large for gestational age the weight estimates calculated at or near term may be enhanced if predictive equations are formulated specifically from the data for such fetuses.

Abdomen↗
PubMed1985

Gestational diabetes mellitus. Correlations between the phenotypic and genotypic characteristics of the mother and abnormal glucose tolerance during the first year postpartum.

We evaluated glucose tolerance during the first year postpartum in 113 women with gestational diabetes mellitus (GDM) diagnosed according to the criteria of the First International Workshop-Conference on GDM and the National Diabetes Data Group. The high incidence of abnormal postpartum glucose tolerance (38% "diabetes mellitus" plus 19% "impaired glucose tolerance") was correlated with certain of the heterogeneous characteristics of the population at the time of antepartum diagnosis. Virtually all women with antepartum fasting plasma glucose (FPG) greater than or equal to 130 mg/dl (GDM class B1) remained abnormal postpartum (21/22 [95%]), which suggests that this group may include women with preexisting glucose intolerance unrecognized before pregnancy. In the remainder, those with FPG greater than or equal to 105-129 mg/dl (GDM class A2) were more likely to be abnormal postpartum than those with FPG less than 105 mg/dl (GDM class A1). Within the A1 and A2 groups, increasing maternal age, relative insulinopenia, and hyperglycemia at 2 h during antepartum OGTT were also associated with a greater likelihood of abnormal glucose tolerance postpartum. The presence of HLA-DR3 and/or -DR4 antigens was not predictive of the status of glucose tolerance during the first year postpartum, although the increased frequency of cytoplasmic islet cell antibodies in A2 and B1 subjects was associated with a high incidence of abnormal postpartum glucoregulation. The high incidence of abnormal postpartum glucose tolerance in all GDM classes makes a compelling case for careful, early, and continuing follow-up of all women with a diagnosis of GDM.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1985

A hypothetical model suggesting suboptimal intrauterine growth in infants delivered preterm.

Infants delivered preterm often reflect accelerated maturation. The present study examines the occurrence of suboptimal intrauterine growth in infants delivered preterm by comparing their birth weights to the weights sonographically predicted for in utero fetuses at similar gestational ages but who ultimately deliver at term. Two weight-predicting formulas based on different sonographic parameters were used. In the fifth, tenth, and 50th percentiles of birth weight, the predicted weights were persistently and significantly greater than the actual birth weights between 24 and 31 weeks' gestation. The results of this model support the concept that the growth of infants delivered prematurely has been suboptimal. The authors hypothesize that preterm delivery may be in some instances another manifestation of the same underlying stress that hastens pulmonary and neurologic maturity.

Birth Weight↗
PubMed1985

Ultrasonic fetal weight prediction: role of head circumference and femur length.

The accurate sonographic estimate of fetal weight is helpful in those instances when the fetal weight estimate might alter clinical management. Most sonographic weight predicting formulas have been based predominantly on measurements from the term fetus and then applied to the preterm fetus. Yet, the morphology of the preterm and term fetus differs considerably. The authors have examined the predictive accuracy of three published sonographic formulas in 69 preterm fetuses scanned within 48 hours of delivery. The mean birth weight was 1396 g. Thirty-nine of the infants were less than 1500 g. Sixty-two percent were products of pregnancies complicated by premature rupture of membranes. The results were compared with new equations derived from combinations of head and abdominal circumferences, biparietal diameter, and femur length obtained from the first 33 fetuses and then tested on the remaining 36. Whereas each formula correlated highly with birth weight, the selected new formula was more accurate than the published formulas by each criteria examined. In contrast to the latter, the mean error (actual minus predicted weight) of most new equations did not significantly differ from zero when tested prospectively. In addition, it appeared that the accuracy of two new formulas not incorporating femur length could be further enhanced in the group of fetuses whose femur length differed from the mean by at least 2 standard deviations by multiplying the predicted weight by the ratio of actual to mean femur length. The authors conclude that the use of head circumference and femur length coupled with a population restricted to the preterm fetus enhances the accuracy of sonographic weight predictions.

Birth Weight↗
PubMed1984

Control of preeclamptic hypertension by ketanserin, a new serotonin receptor antagonist.

We investigated the effect of peripheral serotonin receptor blockade on preeclamptic hypertension in 20 postpartum patients by the use of ketanserin, a serotonin receptor antagonist. In a study consisting of a double-blind crossover with placebo, parenteral ketanserin significantly reduced blood pressure from 167/105 to 126/71 mm Hg compared to a decline from 157/98 to 150/91 mm Hg for the placebo (p less than 0.001). All patients became hypertensive again following infusion, although no abrupt rebound in pressure occurred. Side effects were minimal. The results demonstrate that preeclamptic hypertension can be controlled by ketanserin and suggest that serotonin may have a role in the modulation of preeclampsia.

Adult↗
PubMed1984

Diminished growth in fetuses born preterm after spontaneous labor or rupture of membranes.

We examined biparietal diameter, abdominal circumference, and birth weight in 148 preterm infants to assess fetal growth. A statistically significant proportion of preterm fetuses had biparietal diameter and abdominal circumference values below the fiftieth and tenth percentile levels as compared with that expected in normal fetuses. Similarly, birth weight of infants in the study fell significantly below the fiftieth and tenth percentiles relative to Brenner's curve. We conclude that diminished fetal growth is associated with early delivery secondary to preterm labor or preterm premature rupture of membranes or both. Additionally, since biparietal diameters in preterm fetuses are smaller than those of normal fetuses the prediction of gestational age by cephalometry should be advanced by 7 to 10 days.

Birth Weight↗
PubMed1984

HLA-DR typing as a predictor of MLC compatibility.

Mixed lymphocyte culture reactions between HLA-identical siblings, HLA-DR-identical parent-child and sibling pairs, HLA-DR identical unrelated normal individuals, and cadaver kidney graft donor and recipient pairs were compared for MLC compatibility. Of 34 HLA identical sibling pairs, 31 (91%) showed a percentage of relative response (RR%) of less than 5%. Forty-two of 79 HLA-DR-identical parent-child and sibling pairs (53%), 8 of 61 unrelated individuals (13%) and 4 of 7 cadaver transplant donor-recipient pairs showed %RR values of less than 20%, which is consistent with MLC compatibility. An additional 7 parent-child and sibling pairs and 8 unrelated combinations were in the borderline range yielding %RRs of 20-30%. Median %RR values were significantly increased in the DR-compatible unrelated group as compared with the DR-compatible related group (p less than .001). In the related group pairs matched for HLA-B in addition to HLA-DR had a significantly lower median %RR than pairs matched for HLA-DR only (p less than .001). In addition, a higher frequency of MLC-compatible combinations was found when B/DR-compatible antigens were present in a positive linkage disequilibrium. The same trend was observed in the unrelated population, but the number of B/DR compatible pairs in the population was low. The data demonstrate the range of MLC reactions between HLA-DR-compatible related and unrelated individuals and support the hypothesis that individuals compatible for HLA-B and DR antigens in a strong linkage disequilibrium are more likely to be MLC-compatible.

Female↗
PubMed1984

Urinary estriols in diabetic pregnancy: a reappraisal.

The clinical usefulness of serial urinary estriols was tested in 138 insulin-dependent diabetic pregnant women. No action was taken on an estriol drop if fetal well-being was demonstrated by a reactive nonstress test and/or negative contraction stress test within 24 hours. Of 3085 estriol values, a greater than or equal to 40% estriol drop, confirmed by a greater than or equal to 40% decrease in the estriol-creatine ratio, was observed in 21 tests. In only two of these tests, was fetal distress indicated by a nonstress test or contraction stress test. A significant linear correlation was demonstrated between the mean level of estriol excretion and birth weight, placental weight, and fetal abdominal circumference measured by ultrasound. Chronically low estriol excretion (less than 12 mg per 24 hours at greater than 36 weeks' gestation) related to smaller placentas but not to fetal jeopardy.

Apgar Score↗
PubMed1984

Diminished biparietal diameter and abdominal circumference growth in twins.

Forty-three women with uncomplicated twin pregnancies and reliable menstrual dates had serial ultrasonic measurements of the fetal biparietal diameter (BPD) and abdominal circumference. The 25th, 50th, and 75th fetal BPD and abdominal circumference growth percentiles were generated from this normal twin population and compared with those for singletons. A slowing of both BPD and abdominal circumference growth in twins was noted in the third trimester. However, newborn anthropometric data were collected that suggest that the head circumference of twins is comparable to that of singletons. This discrepancy between ultrasonic BPD and neonatal head circumference in predicting head size may possibly be explained by dolichocephaly attributed to uterine crowding. For the antenatal assessment of growth in twins the authors recommend the use of BPD and abdominal circumference charts derived specifically from such uncomplicated twin pregnancies. When the BPD growth is abnormal, the head circumference and abdominal circumference should be measured to assess whether or not fetal growth is normal.

Abdomen↗