PubMed Health⌕ Search

Biomedical subjects

O Tadmor

Publications and source records attributed to O Tadmor.

17 recordsLinked to original sources
PubMed1998

Assessment of first-trimester nuchal translucency by daily reference intervals.

Increased fetal nuchal translucency measured in the first trimester is associated with an elevated frequency of chromosomal abnormalities, yet no reference intervals for transvaginal sonographic measurements of fetal nuchal translucency in that period of development have been established. The aim of the present cross-sectional study was to construct appropriate gestational age-specific reference intervals for nuchal translucency. Transvaginal ultrasound was used in 180 normal pregnant women between 9 and 14 weeks of gestation. Reference intervals were constructed by the parametric method. These reference intervals were then compared to the traditional threshold value of 3 mm, when applied to 287 women scheduled for amniocentesis or chorionic villus sampling (CVS). Both methods had the same sensitivity, 85.7%, and negative predictive value, 99.6%, in predicting fetal chromosomal abnormalities. However, the specificity of the gestational age-related reference intervals tended to be higher than that of the 3-mm threshold: 94.6% vs. 87.9%. The positive predictive value of the former method was higher than that of the 3-mm threshold: 28.6% vs. 15%. The increased specificity and positive predictive value of these reference intervals are of particular importance when applied to women under the age of 35 years. In those women, the finding of an abnormally thick nuchal translucency can lead to the performance of amniocentesis or CVS. Therefore, using these reference intervals instead of the traditional 3-mm threshold may save a significant number of unnecessary invasive procedures.

Adult↗
PubMed1997

Parental attitudes toward obstetric ultrasound examination.

OBJECTIVE: The aim of the study was to assess the effect of ultrasound examination on parental attitudes and anxieties. MATERIAL AND METHOD: Ultrasound examinations were carried out on 1,089 pregnant women with uncomplicated pregnancies at a mean gestational age of 20.9 weeks (minimum 10 weeks). Before and after the ultrasound examination, patients completed a questionnaire comprising 26 five-point numerical scales relating to anxiety levels, and difference scores for pre- and post-scan levels of fears and anxieties were computed. RESULTS: We showed that the reduction of anxiety following ultrasound examination was inversely related to gestational age, but was unrelated to demographic or medical variables, such as the risk level at the time of the scan. Similarly, anxiety was not reduced because of the presence of the spouse, although the spouse's presence did significantly increase inter-partner bonding. CONCLUSION: This study showed that "routine" ultrasound scan may have significant psychological effects on parental attitudes toward each other and the fetus.

Adolescent↗
PubMed1996

The effect of the amount of feedback on anxiety levels during ultrasound scanning.

This study examined the influence of different levels of feedback and of other situational and buffering variables on the psychological effects of ultrasound examinations of 211 pregnant women. The patients were randomly assigned to two different experimental conditions: high feedback and low feedback. The subjects' levels of anxiety (both trait- and state-anxiety) were measured immediately before and after the ultrasound examination. Overall, there was a significant decrease in the level of state-anxiety, which could not be explained by the different levels of feedback provided. Situational and buffering variables were not found to be related to the degree of psychological benefit produced by the scan.

Adult↗
PubMed1995

The effect of normal childbirth on eyes with abnormalities predisposing to rhegmatogenous retinal detachment.

BACKGROUND: Pregnant women who have high myopia, a history of retinal detachment or retinal holes, or have known lattice degeneration are frequently referred to an ophthalmologist for advice concerning the management of pregnancy and labor, i.e. whether a spontaneous vaginal delivery can be allowed and whether prophylaxis for high-risk retinal pathology is indicated. Many obstetricians still believe that pregnant women with ocular abnormalities predisposing to rhegmatogenous retinal detachment should have an instrumental delivery, and a few even advocate cesarian section. Very little has been written about the management of pregnant women with high-risk retinal pathology, and opinions differ considerably. Patient data on this subject are scarce. METHODS: We studied 10 women who had 19 deliveries (10 prospective and 9 retrospective) and who had a history of retinal detachment, had been diagnosed as having extensive lattice degeneration, or had been treated for symptomatic retinal holes or breaks. The women were followed from the third trimester of pregnancy through labor and delivery into the postpartum period, looking for changes in the retinal status. RESULTS: We found no changes in the retinal status in the postpartum examination. CONCLUSION: We conclude that prenatal treatment of asymptomatic retinal pathology is not indicated and that spontaneous vaginal delivery may be allowed to take place in women with high-risk retinal pathology.

Adult↗
PubMed1995

Anxiety levels of pregnant women during ultrasound examination: coping styles, amount of feedback and learned resourcefulness.

Anxiety levels were measured before and after ultrasound examination in 183 women who underwent the procedure as part of their routine prenatal care. Women were classified according to their preferred mode of information gathering, their amount of available cognitive resources and predetermined feedback conditions. The results indicated significant reductions in state or situational anxiety levels for all subjects while trait anxiety was unaffected. In addition, the results suggested a correspondence between learned resourcefulness and informational coping styles. Women who had higher levels of cognitive resources and actively sought out information showed significantly greater decreases in state anxiety levels. This finding was also true for women who had lower levels of cognitive resources and tended to block out information. The impact of the scan was more profoundly affected by personality repertoires and informational coping styles than by either of the feedback conditions.

Adaptation, Psychological↗
PubMed1994

Post-term pregnancies with normal cardiotocographs and amniotic fluid columns: the role of Doppler evaluation in predicting perinatal outcome.

OBJECTIVE: To study the role of Doppler ultrasound examination in predicting an abnormal perinatal outcome, among post-term pregnancies uncomplicated by an abnormal non-stress test (NST) or reduced amount of amniotic fluid. DESIGN: A prospective study. SETTING: High-risk pregnancy unit, Hadassah Mt. Scopus University Hospital, Jerusalem. SUBJECTS: Seventy-eight women with confirmed gestational age of > 287 days, who had normal initial evaluation and unfavourable cervical examination. INTERVENTIONS: Doppler flow velocity waveforms were recorded from the umbilical and middle cerebral arteries, and from the descending thoracic aorta. MAIN OUTCOME MEASURES: Correlation between Doppler measurements and data regarding delivery. RESULTS: Women who developed signs of fetal distress during labour, or who required intervention because of fetal distress, had elevated umbilical artery systolic/diastolic ratio, decreased middle cerebral artery pulsatility index, and decreased time average aortic blood flow velocity. Umbilical artery Doppler measurements could significantly predict the need for intervention due to fetal distress. CONCLUSIONS: Doppler examination of uncomplicated post-term pregnancies may identify patients with normal results as having a low risk of developing fetal distress during labour. Patients with abnormal Doppler results are prone to need intervention following fetal distress in labour.

Adult↗
PubMed1993

Intrauterine device failure: relation to its location within the uterine cavity.

OBJECTIVE: To investigate the possible role of position of the intrauterine device (IUD) in accidental pregnancies. METHODS: We examined the location of the IUD in 97 normal women 45-60 days post-insertion, and in 25 pregnant women with the device in situ. RESULTS: A cervically located IUD was identified in seven of 97 women (7.2%) after insertion and in 13 of 25 pregnant women (52%) with the device in situ. The odds ratio for a woman with an intracervical IUD to be pregnant compared with a woman with an IUD in the uterus was 13.93 (95% confidence limits 4.13-48.96). Sonographic follow-up of the pregnant women revealed no change in IUD location during early gestation. CONCLUSIONS: We suggest that cases of failed contraceptive action of the IUD may be secondary to a malpositioned device. A sonographic survey can identify displaced devices. Reinsertion of the IUD in such cases is recommended.

Adult↗
PubMed1992

Inhibition of chloroplast CF1-ATPase by vanadate.

Inhibition of ATPase activity by vanadate, having K1/2 of 0.5 mM, was demonstrated in the CF1-ATPase. The Ca(2+)-dependent ATPase activity of the isolated enzyme was inhibited in an allosteric manner by vanadate with a Hill coefficient of 3.19 +/- 0.6. Vanadate also inhibited ATPase and Pi-ATP exchange activities of the chloroplast membrane-bound enzyme. Using 51V NMR it was demonstrated that ATP caused partial release of about 1.87 equivalents while ADP caused additional binding of approximately 1.46 equivalents of vanadate, when added to a solution containing CF1 equilibrated with vanadate. The relevance of these results to a possible involvement of a pentacovalent phosphate as transition state intermediate in the hydrolysis of ATP by CF1-ATPase is discussed.

Adenosine Diphosphate↗
PubMed1992

Prerupture ultrasound diagnosis of interstitial and rudimentary uterine horn pregnancy in the second trimester. A report of two cases.

Pregnancies in an interstitial and rudimentary uterine horn are rare and often fatal varieties of ectopic gestation. Ruptures tend to occur in the second trimester, resulting in maternal morbidity and mortality. Only a few cases of the ultrasonographic diagnosis of unruptured second-trimester interstitial and rudimentary uterine horn pregnancy have been reported. In two such cases second-trimester ultrasonographic examination revealed an unusual pregnancy location, thin uterine wall, incomplete myometrial layer and empty uterus.

Adult↗
PubMed1991

Effect of ketoconazole on steroidogenic human granulosa-luteal cells in culture.

Ketoconazole (KCZ), a widely used antifungal drug, has been reported in humans to inhibit adrenal and testicular steroidogenesis by interfering with the cytochrome P-450-dependent enzymes. The purpose of this study was to investigate the drug effect on steroidogenic human granulosa-luteal cells, obtained by follicular aspiration from mature follicles of gonadotropin-treated women. Cells were cultured in long-term monolayers, and the steroid production was assayed by radioimmunoassay. A profound inhibition of ovarian cell secretion of progesterone (P), testosterone (T) and estradiol was found. At a low concentration (5 micrograms/ml), KCZ failed to inhibit the conversion of pregnenolone to P, mediated by the non-cytochrome 3 beta-hydroxysteroid dehydrogenase-isomerase enzyme (3 beta-HSDH). At a similar concentration, P secretion by human chorionic gonadotropin (hCG; 100 mIU/ml) -treated cells was decreased by 68% (P less than 0.001) and therefore, an inhibitory effect of KCZ on the cholesterol side-chain cleavage enzyme (P-450SCC) was assumed. A similar marked inhibitory effect (81%) (P less than 0.001) on T secretion was observed for hCG-stimulated cells given pregnenolone as substrate. The P-450 aromatase was profoundly inhibited (86%) (P less than 0.001) in a reversible manner, by a similar concentration (5 micrograms/ml) of KCZ. These findings suggest that KCZ has the capability to suppress human ovarian steroidogenesis similarly as in testis and adrenal.

Aromatase Inhibitors↗
PubMed1991

[Morbidity among kibbutz children determined by health interview].

Morbidity in 1,565 children up to the age of 6 years on 28 kibbutzim over a period of 6 days was examined. The data reported in a health interview were compared with those reported to the kibbutz clinics. The health interview gave a morbidity of 38% during the 6 days studied, equivalent to a mean of 23.1 episodes per child per year. Of these sick children, 300 were reported as having visited the clinic, compared with 240 actually recorded as having symptoms/complaints, or 9.3 events per child per year. Nearly all of the morbidity (95%) fell into 4 major categories: respiratory, nervous system and sensory infections and digestive diseases. As reported in the health interview, the clinic was visited in 50% of the episodes; the frequency and types of diseases reported were similar for both the clinic records and the health interviews. The most clinic visits were for acute infectious diseases (100%); the least for chronic diseases (none). According to the health interview, 62% of those visiting the clinic were referred to a physician and 38% to a nurse. The corresponding percentages from the clinic records were 60 and 40, respectively. In general, the relative distribution by disease categories was similar in both health interviews and clinic records. The only significant differences were for respiratory diseases, in which a higher incidence was reported in the health interview. In the matching test between health interviews and records of clinic visits, only partial matching was found. There was 34% corroboration of dates of visit according to the health interview compared with the clinic records. With regard to diagnoses, the rate of match was only 29%.

Child Health Services↗
PubMed1991

Heart rate as a predictor of first-trimester spontaneous abortion after ultrasound-proven viability.

To discover whether first-trimester spontaneous abortion can be predicted by embryonic heart rate (EHR), we performed a cross-sectional study during the first trimester of pregnancy using high-frequency transvaginal sonography combined with pulsed Doppler. Heart rate was measured in 603 embryos; of these, 580 continued beyond 13 weeks' gestation and 23 ended in first-trimester spontaneous abortion. Based on the continuing pregnancies, we constructed and compared EHR nomograms relating to gestational age, mean diameter of the gestational sac, and crown-rump length (CRL). Embryonic heart rate correlated best with CRL (r = 0.87), and the correlation was best described by a second-degree polynomial regression equation. The mean EHR increased progressively from 110 beats per minute (bpm) at CRL of 3-4 mm to 171-178 bpm at CRL 15-32 mm. At CRL greater than 32 mm, the EHR remained stable at a mean of 170 bpm. The EHRs of the 23 embryos that spontaneously aborted in the first trimester were evaluated according to these nomograms. In 15 cases, the EHR fell outside the 95% confidence interval for CRL (sensitivity 65%), but it was within normal limits in eight (false-negative rate 35%). In ten embryos for which pregnancy continued beyond 13 weeks, the EHR fell outside the 95% confidence interval (specificity 98%, false-positive rate 2%). Our findings suggest that EHR measurements in early pregnancy may be useful in the prediction of first-trimester spontaneous abortion after ultrasound-proven viability.

Abortion, Spontaneous↗
PubMedDate not supplied

Analysis of umbilical artery flow parameters during fetal variable decelerations using computerized Doppler waveforms.

Umbilical artery velocity waves were obtained by Doppler ultrasonography before, during, and after 20 episodes of fetal heart rate (FHR) variable decelerations (VD) during the active stage of labor in 8 women. During 50% of the VD periods, the umbilical artery resistance flow parameters increased significantly (p < 0.01). The increase in resistance preceded the decrease in FHR in six episodes (30%) of VD (AR-VD group; arterial resistance VD) and did not precede the change in FHR in another ten episodes (50%) of VD (VR-VD group; venous resistance VD). In the AR-VD group the FHR accelerations occurred before the decelerations in only 1 case (17%), while in the VR-VD group FHR accelerations preceded the decelerations in 8 out of the 10 episodes (80%). Using these Doppler studies, it may be possible to differentiate between two groups of VD: AR-VD - which are caused by umbilical artery occlusion and thus preceded by a measurable increase in umbilical artery resistance - and VR-VD - which are not preceded by a measurable increase in umbilical artery resistance and may be caused by fetal hypoxia.

Adult↗
PubMedDate not supplied

Continuous determination of umbilical artery flow parameters during fetal bradycardia using computerized analysis of Doppler wave forms.

Umbilical artery flow curves were obtained by Doppler ultrasonography before, during, and after episodes of fetal bradycardia in the active stage of labor in 6 women. Between 126 and 1,607 Doppler wave forms were analyzed for each patient. During the periods of bradycardia all the umbilical artery resistance flow parameters increased (p < 0.00001). The increase in resistance did not precede the change in heart rate. This study presents an accurate and reproducible method for continuous evaluation of the changes in the impedance of fetal blood flow during fetal heart rate changes, thereby enabling detailed assessment of circulatory disturbances occurring during labor and delivery.

Blood Flow Velocity↗
PubMedDate not supplied

Prediction of second trimester intrauterine growth retardation and fetal death in a discordant twin by first trimester measurements. Case report and review of the literature.

Ultrasound examination at 9 weeks of gestation in a 34-year-old primigravida showed a twin pregnancy, with discrepancy in the sizes of the two gestational sacs, whereas the crown-rump lengths and fetal heart rates were virtually identical-the result being an abnormal sac size/crown-rump length ratio (early oligohydramnios). By 14 weeks discordant heart rates and umbilical artery flow velocities were detected, the discordance between the twins increasing as pregnancy progressed. Biparietal diameters, femoral lengths, and abdominal circumferences were also progressively discordant, and at 28 weeks the smaller twin had no heart beat. At 30 weeks the patient was delivered of a live 1,350-gram infant and a 400-gram dead fetus. This case suggests, in contradistinction to several previous reports, that fetal discordance in twin pregnancies (and perhaps intrauterine growth retardation in general) may be present as early as the first trimester.

Adult↗