Biomedical subjects

R Sabbagha

Publications and source records attributed to R Sabbagha.

10 recordsLinked to original sources

PubMed1995

Isolated hyperechoic fetal bowel: significance and implications for management.

OBJECTIVE: The objective of this study was to determine the significance of isolated hyperechoic fetal bowel. STUDY DESIGN: Forty-five cases with prospective, ultrasonographic diagnosis of isolated hyperechoic fetal bowel were reviewed. Fetal variables, including aneuploidy, deoxyribonucleic acid studies for cystic fibrosis, congenital infection, growth retardation, and intrauterine death were reported. RESULTS: Thirty-four of the 45 cases (76%) resulted in live-born infants without detected abnormalities. However, hyperechoic bowel was associated with cystic fibrosis in two cases (4%), congenital infection in two cases (4%), and fetal alcohol syndrome in one case. Termination of pregnancy was elected in three cases and intrauterine fetal death occurred in three cases (7%). Growth retardation was observed in five of 39 (13%) live-born infants. CONCLUSION: Isolated hyperechoic fetal bowel is associated with significant pathologic disorders. Women whose fetuses are diagnosed as having isolated hyperechoic bowel should be offered additional prenatal diagnostic options, including maternal serologic studies for congenital infection, fetal karyotype, and deoxyribonucleic acid testing for cystic fibrosis. In addition, continuing ultrasonographic evaluation of fetal growth and antenatal biophysical assessment should be considered.

Cystic Fibrosis↗

PubMed1993

Echo patterns of benign cystic teratomas by transvaginal ultrasound.

The transvaginal ultrasound echo patterns of 39 surgically proven cystic teratomas were retrospectively reviewed. Six different ultrasound echo patterns could be differentiated, ranging from purely cystic to densely echogenic. Importantly, in 82% of the tumors, areas of dense echogenicity were noted. Although the transvaginal appearance of cystic teratomas may allow correct preoperative prediction, the variable nature of the echo patterns makes differentiation from malignant tumors difficult.

Journal Article↗

PubMed1988

Caution in antenatal intervention.

We assessed 18 fetuses who harbored a urinary tract malformation that was diagnosed by antenatal sonography. The antenatal diagnosis corresponded to the postnatal diagnosis in 66 per cent of the cases. We review the course of 6 fetuses who had catheters placed percutaneously to drain dilated urinary tracts that were believed to be caused by posterior urethral valves (5) or an obstructed megaureter (1). Only 2 of these fetuses exhibited valves postnatally. No fetus had any recognized benefit from the antenatal intervention. We found that sonography may not readily differentiate fetuses with hydronephrosis with obstruction from those without obstruction. From this experience we conclude that intervention in pregnancies suspected of harboring a fetus with a malformed urinary tract should be done cautiously. Antenatal sonography is useful to identify the fetus with a dilated urinary tract. This identification permits perinatal specialists to be alerted so that preparations for reconstructive surgery in such cases can be made early postpartum.

Female↗

PubMed1987

Prenatal effects of maternal-fetal HLA compatibility.

Both retrospective studies of idiopathic aborters, as well as prospective studies of normal couples, have shown reduced fertility among couples sharing HLA antigens. However, the effects of maternal-fetal histocompatibility on surviving embryos are largely univestigated. We thus prospectively studied 53 healthy, fertile women whose timed pregnancies were verified within 21 days of conception. Maternal-fetal histocompatibility status was determined for HLA-A,-B, and -DR locus antigens. Fetal growth rates were monitored by ultrasound at 8, 12, and 20 weeks gestation. Neonates were weighed, measured (birthlength, chest circumference, head circumference), and examined within 72 h of delivery (116 major and minor anomalies) in standardized fashion by one of two geneticists. Although no significant differences were found between infants compatible and incompatible at the HLA-A or HLA-B locus, significant differences were observed between HLA-DR compatible and incompatible infants for sex ratios (p less than .003) and minor anomaly rates (p less than .05). Although differences in mean birthweights between HLA-DR compatible and incompatible infants were not significant in this sample, HLA-DR compatible infants were on average 200 grams smaller than HLA-DR incompatible infants. We interpret these findings as evidence for selection against histocompatible fetuses throughout gestation, particularly with respect to HLA-DR compatibility. Potential immunologic and genetic mechanisms are discussed.

Adult↗

PubMed1986

Chorionic villus sampling in continuing pregnancies. I. Low fetal loss rates in initial 109 cases.

Among the first 150 women who agreed to have chorionic villus sampling after receiving counseling and giving informed consent, 41 proved ineligible. In six (5.5%) of the remaining 109 cases in which chorionic villus sampling was performed, we were unsuccessful in obtaining an adequate amount of villi to permit diagnostic testing. In the single loss, fetal viability was confirmed 2 weeks after sampling; however, fetal death became evident 3 weeks later. In four (3.7%) cases the pregnancies were terminated because of abnormal results, and in one (0.9%) case the pregnancy was electively terminated after normal results. Among the 41 completed pregnancies no anomalies were evident in the infants. There were two premature deliveries; one of these two infants died shortly after birth following premature rupture of the membranes at 29 weeks' gestation. All undelivered cases were progressing normally at the time of submission.

Abortion, Induced↗

PubMed1984

Sister chromatid exchanges after exposure to ultrasound and mitomycin C.

A pilot study was designed to determine whether a synergistic ability to produce sister chromatid exchanges exists between ultrasound and mitomycin C, an alkylating agent known to induce sister chromatid exchanges. Bromodeoxyuridine-containing cells from human lymphocyte cultures were randomized into one of four exposures: (1) unexposed controls, (2) 20 minutes of pulsed ultrasound (3.5 MHZ), (3) mitomycin C alone, or (4) mitomycin C and 20 minutes of pulsed ultrasound. The mean sister chromatid exchange frequencies were 6.7 control cells, 7.5 cells exposed only to ultrasound, 8.1 cells treated with both ultrasound and mitomycin C, and 10.4 cells treated with mitomycin C alone. Neither X2 tests for differences in the four distributions nor analysis of variance for interaction between ultrasound and mitomycin C was significant. Our results suggest that individuals receiving alkylating agents are not likely to be highly susceptible to any deleterious effects of ultrasound. However, these results remain tentative pending repetition of studies and development of more appropriate in vitro exposure systems.

Adult↗

PubMed1984

Elevated alpha-fetoprotein and acetylcholinesterase associated with hydrocele.

Elevated amniotic fluid alpha-fetoprotein and presence of acetylcholinesterase were detected in a pregnancy that resulted in an infant whose only abnormality was a hydrocele. Although these amniotic fluid findings are usually indicative of a serious fetal anomaly, our report indicates that this is not always the case.

Acetylcholinesterase↗

PubMed1983

A simple estimated fetal weight equation based on real-time ultrasound measurements of fetuses less than thirty-four weeks' gestation.

Based on ultrasonographic mensuration, a number of equations have previously been devised for the purpose of estimating fetal weights. The objective of this study was to develop a mathematical equation that is simple, accurate, and easy to use when applied to preterm or low-birth weight fetuses (less than 2,500 gm). Real-time ultrasound measurements of fetal biparietal diameters (BPDs) and abdominal circumferences (ACs) were obtained in 62 pregnant women within one week of premature delivery. Mean gestational age and mean birth weight +/- SD for this study group of neonates were 28.5 +/- 3.5 weeks and 1,135 +/- 343 gm, respectively. With the aid of computer analysis, a simple regression equation was derived: EFW = (BPD x AC x 9.337) - 229. When predicted estimated fetal weight (EFW) was compared with actual birth weight (ABW), multiple regression analysis demonstrated a correlation coefficient (R) of 0.957. Preliminary results on 19 patients of a prospective study showed an absolute mean difference between the computed EFWs and the ABWs to be within 7.0% of ABW (70 gm/kg of ABW). The standard deviation of the difference was 9.3% of ABW (93 gm/kg of ABW). Based on these data, this simple equation appears to be clinically reliable and easy to use when estimating weights of preterm or low-birth weight fetuses of less than 2,500 gm.

Birth Weight↗

PubMed1980

Serial ultrasonography to assess evolving fetal macrosomia. Studies in 23 pregnant diabetic women.

Serial ultrasound estimates of fetal biparietal diameter and abdominal circumference were used as differential indices of intrauterine growth of insulin-insensitive and insulin-sensitive structures, respectively, in 23 White's classes A to C diabetic women. Biparietal diameter in all fetuses conformed to growth patterns for fetuses of nondiabetic mothers. However, two patterns were noted for abdominal circumference. Normal increases occurred in 13 fetuses; in the remaining ten, growth of abdominal circumference exceeded upper normal limits from weeks 28 to 32 of gestation onward. This latter group with putative "accelerated somatic growth" in utero had more immunoreactive insulin in amniotic fluid, weighed more at birth, and had more subcutaneous fat. Serial differential ultrasonography may be useful for detecting evolving macrosomia in diabetic pregnancies, and fetal insulin or insulin-like principles may contribute to the macrosomia.

Birth Weight↗

PubMed1980

Prenatal diagnosis of harlequin ichthyosis.

We report the successful prenatal diagnosis of ichthyosis in the fetus of a woman whose previous liveborn child was affected with "harlequin ichthyosis". The fetal diagnosis was established through analysis of ultrasonographically guided fetoscopic skin biopsies. These biopsies showed premature hyperkeratosis, most marked around hair follicles and sweat ducts, and forming plugs of hyperkeratotic debris. These observations were in distinct contrast to those in control fetuses, whose epidermis consists of squamous epithelium only a few cells in depth with minimal keratinization.

Adult↗