Biomedical subjects
Publications and source records attributed to R Haynes de Regt.
A pregnancy complicated by Vel isoimmunization is presented. Despite known immunoglobulin G component and significant titer rise, hemolytic disease of the newborn was not present. The maternal and neonatal significance of Vel sensitization is discussed.
Transvaginal ultrasonography was performed in 139 patients at risk for ectopic pregnancy. Among these patients, 22 ectopic pregnancies and 117 intrauterine pregnancies were eventually confirmed. Transvaginal ultrasonography definitively identified 18 of 22 (82%) ectopic pregnancies at initial evaluation by either direct visualization of an ectopically placed gestational sac (N = 14) or failure to visualize an intrauterine gestational sac combined with a level of the beta-subunit of human chorionic gonadotropin greater than 1300 mIU/ml (First International Reference Preparation) (N = 4). Transvaginal ultrasonography definitively diagnosed 103 of 117 (88%) intrauterine pregnancies at initial evaluation. Eighteen patients could not be definitively diagnosed by transvaginal ultrasonography at initial evaluation because nonvisualization of a gestational sac and a beta-subunit of human chorionic gonadotropin value less than 1300 mIU/ml. Evaluation of this group with serial measurements of beta-subunit of human chorionic gonadotropin, repeat ultrasonography, or both, revealed ectopic gestation (N = 4), early intrauterine pregnancy (N = 4), and complete abortion (N = 10).
Sarcoidosis is usually a benign and self-limited disease, but it can occasionally be quite severe. It affects individuals most often during the reproductive years. This report reviews cases of sarcoidosis and pregnancy during a ten-year period at Downstate Medical Center. Eleven patients were stable, two experienced disease progression, and two died from complications of severe sarcoidosis. Factors indicating a poor prognosis included parenchymal lesions on chest x-ray, advanced roentgenologic staging, advanced maternal age, low inflammatory activity, requirement for drugs other than steroids, and presence of extrapulmonary sarcoidosis. Management plans are delineated for patients with advanced sarcoidosis. Some patients require evaluation before pregnancy to establish chronicity, baseline pulmonary function, inflammatory activity, roentgenographic staging, and response to treatment. Only then can the patient be given an accurate prognosis for either an uncomplicated pregnancy or one requiring intensive management by the pulmonary and perinatal teams.