Biomedical subjects

R Chaoui

Publications and source records attributed to R Chaoui.

At least 109 records · Page 6Linked to original sources

PubMed1995

[An isolated fetal kidney cyst as a sign of congenital neuroblastoma. A case report and overview of the literature].

As a normal scan at 20 weeks of gestation a pregnant woman was referred at 36 weeks because of a cystic tumour in the fetal kidney. The cyst, 27 mm in diameter, was localised at the cranial pole of the right kidney. A fetal neuroblastoma was suspected. At the fourth day after birth adrenalectomy was performed and the histological finding confirmed the prenatal diagnosis. Two years later the child is healthy. In review of the literature we found that sonographic pattern and localisation of fetal neuroblastoma are different, but in all cases the detection was performed in the third trimester of gestation.

Adrenal Gland Neoplasms↗

PubMed1994

[Fetal color Doppler echocardiography. Part 1: General principles and normal findings].

The first part gives an overview of the practical application of colour-coded Doppler sonography in foetal cardiology. After a comparison between colour-coded and pulsed spectral Doppler in the assessment of foetal intracardiac haemodynamics, the basic principles of colour Doppler are presented. Some practical aspects important in the optimal analysis of the foetal heart are emphasised considering the possibilities and limits of the method. The typical patterns of colour Doppler flow in normal foetal hearts and possible pitfalls are explained viewing different cross-section planes. After the analysis of the cardiac structures in Real-Time, the colour Doppler sonography enables the examiner to assess rapidly and reliably the intracardiac haemodynamics in the foetus. This diagnostical mean improves the accuracy of foetal echocardiography in the diagnosis of congenital cardiac diseases.

Blood Flow Velocity↗

PubMed1994

[Fetal color Doppler echocardiography. Part 2: Abnormalities of the heart and great vessels].

The second part gives an overview of the usefulness of colour Doppler in the diagnosis of congenital heart anomalies in the foetus. Typical colour Doppler findings in anomalies of the right ventricular inflow and outflow tract are presented especially in tricuspid atresia, in Ebstein's anomaly, in pulmonary stenosis and pulmonary atresia. Furthermore exposed are the findings in malformations of left ventricular inflow and outflow tract like in hypoplastic left heart syndrome or in aortic stenosis. The typical shunt patterns detected in atrioventricular or ventricular septal defects are also presented. The analysis of the perfusion of the great vessels bei colour Doppler is important and enables a reliable assessment of some cardiac defects like the Tetralogy of Fallot, the transposition of great arteries or the double outlet right ventricle. At least the application of the colour coded M-Mode echocardiography is explained. Colour Doppler echocardiography is a non-invasive method which is helpful in the detection and the description of abnormalities of the foetal heart and is nowadays indispensable in the prenatal diagnosis of congenital heart defects.

Blood Flow Velocity↗

PubMed1994

[Ultrasound measurements of the fetal heart in the 4-chamber image plane].

Foetal cardiac measurements performed in the four-chamber-view plane were performed in uncomplicated pregnancies between the 20th and the 40th week of gestation. Using cine-loop- and zoom-techniques, the heart length, width, area, and width/length ratio (n = 143) were measured. Including the thoracic diameter and the thoracic area (n = 128), the ratios heart width/thoracic width (CT-ratio) and heart area/thoracic area (CTA-ratio) were also calculated. Normal ranges for the measured parameters and calculated ratios were constructed. Viewing the foetal four-chamber-plane is nowadays a routine scan in obstetrics, and such proposed reference curves could help the sonographer, to detect an abnormal heart and differentiate heart dilation from normal heart in a growth-retarded foetus.

Echocardiography↗

PubMed1994

[Non-puerperal mastitis in real time and color Doppler ultrasound].

Differential diagnosis distinguishing between nonpuerperal mastitis and inflammatory cancer of the breast is difficult, the conventional method being mammography. In our study, we present the typical findings gained by sonography of 16 patients with nonpuerperal mastitis. They do not differ significantly from those cases with breast cancer. From these 16 patients, 7 were additionally examined using Colour and Pulsed Wave Doppler Sonography. International literature offers little practical knowledge in this field. In the immediate surroundings of the inflammation, we were able to represent up to four arterial vessels per patient. The parameters of the flow velocity wave form of these vessels were compared to those of the vessels in the correspondent quadrant of the contralateral breast. In all cases, the maximum systolic and the minimum end diastolic velocities were higher than in the contralateral breast, giving evidence of an increased vascularity. In 6 cases, the pulsatility and resistance indices in the inflammatory vessels were lower because of a decreased peripheral resistance of the vessel. Under therapy with antibiotics or Bromocriptine, these parameters were equalized in both breasts. The model of nonpuerperal mastitis shows, that Colour and Pulsed Wave Doppler Sonography makes it possible to differentiate tumours of the breast on the basis of an analysis of their vascularity and the comparison with the parameters of the vessels in the contralateral breast. The effects of a pharmacological therapy on the vascularity of breast tumours can also be measured with this method.

Abscess↗

PubMed1994

[Ultrasound measurements of the diameter of the aorta and pulmonary trunk of the fetus].

Fetal cardiac measurements derived in the five-chamber and the short-axis view were performed in uncomplicated pregnancies between the 20th and the 40th week of gestation. Using cine loop and zoom techniques, the diameters of the aortic and pulmonary valve were measured (n = 157) and the pulmonary trunk/aorta ratio calculated. Normal ranges for both parameters were constructed and correlated with gestational age. Both diameters showed a linear increase during gestation (aorta r = 0.87, pulmonary trunk r = 0.91). The mean pulmonary trunk/aorta ratio had a constant value of 1.25 and showed no changes throughout pregnancy. In 128 fetuses the heart width was further measured and the vessel diameters were presented in correlation to the heart width.

Aorta, Thoracic↗

PubMed1994

[Cystic kidney dysplasia of variable expression--prenatal ultrasound, cytogenetic and patho-anatomic findings based on 3 case examples].

The present study reports on 3 cases of cystic renal dysplasias of Potter II type with variable characteristics and different clinical symptoms. The prenatal sonography revealed multicystically altered kidneys in the 19th to 33 rd week of gestation. Amniotic fluid cells and fetale lymphocytes were investigated to exclude possible chromosomal disorders. In case one, a unilateral cystic renal dysplasia was diagnosed by sonography in the 19th week of gestation. The chromosome analysis revealed one additional and altered chromosome 22 (partial trisomy). In case two, a bilateral cystic renal disease with oligohydramnios was distinguished in week 21 of gestation. In both cases, the pregnancies underwent artificial abortions and the stillborn infants were subjected to post mortem examinations. The patho-anatomical examinations confirmed the results of prenatal diagnoses and the classification of the cystic renal alteration as renal dysplasia of Potter II type. In case two, extrarenal malformations were found additionally. In case three, sonography revealed a unilateral multicystic kidney. In this case, there had not been any clinical symptoms in the prenatal stage, neither originating from the affected organ nor from other disorders. After delivery at predicted day a unilateral nephrectomy was performed because of space-consuming growth inside the abdominal cavity.

Abortion, Eugenic↗

PubMed1992

[Single umbilical artery--consequences of prenatal diagnosis].

The authors report about the prenatal diagnosis of 34 cases of fetuses with a single umbilical artery (SUA) observed at the Perinatal Center of Charité. Between January 1989 and June 1991 the SUA has been associated with some adverse perinatal events, such as low birth weight (35%), congenital malformations (35%), perinatal mortality (11%) and placental alterations (76%). The incidence was not higher in girls than in boys. We did not find any chromosomal anomalies in our cases. An accurate ultrasonographic examination of the SUA in the 16th to 20th week is very important. The prognosis of the newborn could be improved by efficient diagnosis and optimum management of pregnancy and of delivery at a perinatal center.

Congenital Abnormalities↗

PubMed1992

[Choroid plexus cysts in the 2d trimester--an indication for trisomy 18].

The application of high resolution ultrasound in the prenatal diagnosis enables a detailed differentation of the intracerebral structures in the fetus. In a period of 16 months (Jan. 1990-June 1991) we diagnosed at the "Center for prenatal diagnosis and therapy" at the Charité's Hospital in 14 fetuses among 1800 investigated plexus chorioideus cysts. A rapid karyotyping after cordocentesis was performed in 11 cases. In 3 of them a trisomy 18 could be detected. In one fetus having a normal karyotype we could find besides the cysts multiple structural anomalies. In these 4 cases the termination of pregnancy was performed. In the other 10 pregnancies we could observe a spontaneous regression of the plexus cysts. These results suggest that the prenatal diagnosis of plexus chorioideus cysts is a indication for cytogenetic evaluation in order to detect a trisomy 18.

Abnormalities, Multiple↗

PubMed1992

[Prenatal diagnosis of truncus arteriosus communis (type I) in diabetic pregnancy].

Recently Ferencz et al. [6] using the datas of the Baltimore-Washington Infant Study found a predominance of double outlet righ ventricle and truncus arteriosus communis among the congenital heart diseases of newborns of diabetic mothers. This paper reports about the prenatal diagnosis of a truncus arteriosus communis Type I in a 23 year old pregnant with insulin-dependent diabetes mellitus (White B). The diagnosis was performed in the 25th week using Real-Time- and Color-Doppler-sonography. The important features in the prenatal differentialdiagnosis from a tetralogy of Fallot are explained. The optimal management of pregnancy, the delivery at a perinatal center with subsequent operative correcture could improve the prognosis of the newborn.

Diabetes Mellitus, Type 1↗

PubMed1991

[Tracheal atresia--a special association with esophageal atresia and hydramnion].

This case report describes the prenatal diagnosis of an oesophageal atresia with the previously unpublished associated malformation of tracheal atresia. The knowledge of associated malformations or deformations in prenatally diagnosed oesophageal atresia can considerably improve the prognosis by an optimised post partum care of the newborn. Tracheal atresia can at present not be diagnosed prenatally; the possibility to identify it remains an isolated case and must therefore be taken into consideration whenever an oesophageal atresia is observed.

Abnormalities, Multiple↗

PubMed1991

[Clinical significance and fetal outcome in end-diastolic decreased flow in the umbilical artery and/or fetal aorta: analysis of 51 cases].

The AEDV in the umbilical artery or the foetal aorta is considered to be the most severe waveform abnormality. Using pulsed Doppler, we found such a waveform in 51 foetuses out of 954 high-risk pregnancies (33/51 in both vessels, 17/51 aorta only and 1/51 umbilical artery only). A reverse flow was registered in 24 foetuses. The outcome was compared with that of a control group (n = 72) showing normal Doppler findings. The following parameters were highly significant (p less than 0.001): Rate of Caesarean section owing to foetal distress (85.3% to 4.8%), of growth retardation (IUGR) (66.7% to 6.0%), of premature delivery (73.5% to 7.5%), of low postnatal pH- and Apgar score (73.5 to 12.1%), of admission to the neonatal intensive care unit (94.1% to 8.6%), of morbidity (35.3% to 2.3%) and of mortality (41.1% to 0%). We observed 17/51 intrauterine and 4/51 postnatal deaths. The rate of malformations was 35.3% with 4 cases of aneuploidy. Considering the malformations, the rate of corrected mortality was 23%. We found, that the association of an AEDV and the absence of severe IUGR is highly suspicious of malformation. We also observed, that congenital heart diseases (CHD) could lead to an AEDV too. An AEDV precedes a pathological cardiotocogram (CTG) with a latency of 0 to 35 days (mean 9.5 days). This latency is not predictable, but we think, that a reliable assessment of jeopardy is possible by analysing further vessels (Aa. arcuatae, A. renalis, A. carotis interna): 72.5% of the foetuses with AEDV had high indices in the carotid artery and 93.1% among these showed a pathological CTG pattern.(ABSTRACT TRUNCATED AT 250 WORDS)

Aorta↗

PubMed1991

[Fetal echocardiography. II. Normal and pathological anatomy in real-time ultrasonography].

The paper is a practical approach to fetal echocardiography using real-time ultrasound. The normal sonoanatomy of the fetal heart is presented for the non-cardiologist. The basic cross-sectional views are explained as well as the systematic analysis of the different fetal heart structures. The main heart malformations are reviewed with a description of their appearance in prenatal real-time-ultrasound illustrated by some figures. The examination of the fetal heart could be easy learned, but the assessment and the differentiation of congenital heart defects are only possible by a systematic approach, experience and patience. The examination of the fetal heart should be therefore involved in the screening-ultrasound performed by the prenatal sonographer and suspicious findings has to be referred to a perinatal center.

Echocardiography↗

PubMed1991

[Fetal echocardiography: Part III. Fetal arrhythmia].

The paper is a review of cardiac arrhythmias, as the most common cardiological symptom in the fetus. After exposing the basic knowledge of fetal pathophysiology necessary for the better und understanding of cardiac rhythm disturbances in the fetus, the classification of fetal arrhythmias is presented. The possibilities of modern diagnosis and differential diagnosis, such us the fetal ECG, the control of the heart rate patterns and the sonography are discussed. The usefulness of the real-time-directed and color-coded M-Mode-echocardiography in the diagnosis and classification of arrhythmias are emphasized as well as the significance of the intracardiac Doppler and simultaneous Doppler recordings in the inferior vena cava and aorta. The indications, ways and drugs used in the intrauterine therapy of arrhythmias are presented. The differentiated management related to the diagnosis is described, after reporting about our own experience with 261 fetuses with arrhythmias (27 tachycardias, 21 bradycardias and 213 ectopic beats).

Anti-Arrhythmia Agents↗

PubMed1990

[Assessment of peripheral hemodynamics of the fetus using Doppler ultrasound].

Analysis of foetal haemodynamics using Doppler ultrasound is widely applicable in obstetrics in assessing foetal well-being. To evaluate the parameters of foetal circulation we examined 205 pregnant women to ascertain normal velocity ranges of the foetal internal carotid artery and the foetal renal artery. By establishing the ratio between the pulsatility indices of the foetal internal carotid artery, the foetal aorta and the renal artery of the foetus, standards of these were obtained. From this it seems to be possible to gain information on the extent and degree of the centralisation of foetal blood circulation.

Blood Flow Velocity↗

PubMed1990

[Prenatal use of pulsed Doppler ultrasound within the scope of the differential diagnosis of bilateral kidney abnormalities].

Pulsed Doppler ultrasound was used in the differential diagnosis of 22 cases suspected of bilateral malformations of the foetal kidneys. In cases of kidney malformations, the pulsatility indices (PI) of the umbilical artery and the foetal aorta were in the normal range. In cases showing pathological PI values of both vessels, we found a severe intrauterine growth (IUGR) retardation with oligohydramnion. These results underline the importance of pulsed Doppler as a non invasive means in the management of oligohydramnions to differentiate among bilateral kidney malformations and IUGR.

Abnormalities, Multiple↗

PubMed1990

[Assessment of uteroplacental circulation in uncomplicated pregnancies using pulsed Doppler ultrasound].

The Doppler sonography enable as a new non-invasive procedure the assessment of the uteroplacental circulation. 209 blood flow measurements (pulsed wave Doppler) were recorded between the 20th and 40th weeks of gestation from the arcuate arteries in 130 women with uncomplicated pregnancy. The S/D Ratio, the Resistance Index (RI) and the Pulsatility Index (PI) were calculated. These Indices show throughout the observation time persisting low values which reflect the optimal uteroplacental circulation in a system with low downstream impedance. We found that the S/D Ratio and the RI are appropriate parameters in the qualitative analysis of the uteroplacental perfusion. On the other side we could demonstrate that the PI depends on the maternal heart rate which explains the high variability of the values. Therefore is the PI not appropriate for the impedance measurements in uteroplacental vessels.

Blood Flow Velocity↗

PubMed1990

[Qualitative analysis with Doppler spectra of the umbilical artery and fetal aorta in normal pregnancies].

Blood flow velocity waveforms were recorded between the 20th and 40th week of gestation from the umbilical and fetal aorta (n = 230 each) in 130 uncomplicated pregnancies. The S/D ratio, the Resistance Index (RI) and the Pulsatility Index (PI) were calculated. In the umbilical artery the indices showed a significant decrease in the observation interval. In the fetal aorta we could not register any significant change of these indices. All values are presented as reference curves. The importance of the Doppler assessment of the circulation in these vessels for the management of high-risk pregnancy is emphasized.

Aorta↗