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Biomedical subjects

S H Golde

Publications and source records attributed to S H Golde.

28 records · Page 2Linked to original sources
PubMed1982

Fetal lung maturity: the adjunctive use of ultrasound.

Ultrasonic cephalometry (BPD) was retrospectively studied in 268 patients at risk for the development of hyaline membrane disease (HMD). Thirty-seven patients were diagnosed as having diabetes and were excluded. Of the remaining 231 patients, 123 (53%) were found to have a biparietal diameter of (BPD) greater than or equal to 9.2 cm. There were 92 patients delivered within 5 days of scanning and none developed HMD. A BPD of 9.2 cm corresponded to an L/S ratio of 2.8 (r = 0.45, p less than 0.05). The above results indicate that it is safe to deliver a nondiabetic patient in whom a fetal BPD of 9.2 cm has been obtained.

Amniotic Fluid↗
PubMed1982

Real-time ultrasound of the placenta in assessment of fetal pulmonic maturity.

The use of ultrasound is a noninvasive method of assessing fetal maturity. However, in order for it to be a substitute for amniocentesis, a high degree of accuracy is required. Static ultrasound examination of placental development has revealed certain patterns of maturity which have suggested to be predictors of fetal pulmonary maturity. This study analyzes 100 patients near term for the accuracy of placental grade in predicting pulmonary maturity when measured by the lecithin/sphingomyelin ratio and by clinical development of the respiratory distress syndrome in the neonate. A mature placental grade (Grade III) determined by real-time sonography corresponded to fetal lung maturity in all cases (n = 15). Placental grade as determined by this methodology appeared to be an accurate predictor of fetal maturity in the population examined.

Amniotic Fluid↗
PubMed1981

Antepartum fetal surveillance in diabetic pregnant patients.

The antepartum fetal surveillance (biochemical and biophysical) data of 140 pregnant diabetic patients were evaluated. We determined how often intervention occurred on the basis of abnormal tests and correlated each test with neonatal outcome. Fifteen of the total 140 patients had their pregnancies terminated because of abnormal biochemical and/or biophysical tests. An abnormal estriol (E3) value preceded the abnormal antepartum fetal heart rate testing in eight of 10 instances. We conclude that the major benefit of the antepartum fetal surveillance techniques, in this group of patients and under the present scheme, is in determining when not to intervene, thus allowing safe prolongation of pregnancy.

Estriol↗
PubMed1980

Effect of blood in amniotic fluid on the detection of phosphatidylglycerol.

Samples of amniotic fluid were mixed with serum or red blood cells (RBC) in order to determine the effect of blood contamination on the detection of phosphatidylglycerol (PG). Samples of amniotic fluid was obtained from patients in the second trimester of pregnancy and at term, PG standard was added to half of the aliquots of the second-trimester fluid. The samples of fluid were tested before and after the addition of maternal or fetal serum or RBC in concentrations up to 20%. Two-dimensional thin-layer chromatographic procedures were performed to determine the presence or absence of PG. The results obtained showed that serum of RBC contamination of amniotic fluid without PG did not result in the appearance of a PG spot on the chromatographic plate. Neither serum nor RBC contamination interfered with the detection of PG in those fluids in which it was present. Maternal and fetal blood were similar in their failure to affect the detection of PG. These data suggest that PG determination for fetal lung maturity is a reliable test in the presence of bloody amniotic fluid.

Amniotic Fluid↗
PubMed1980

A blind comparison study of the lung phospholipid profile, fluorescence microviscosimetry, and the lecithin/sphingomyelin ratio.

Two hundred thirty-six amniotic fluid samples from 215 patients were analyzed for the acidic phospholipids, phosphatidylglycerol (PG) and phosphophatidylinositol (Pl), using two-dimensional chromatography. One hundred seventy-eight samples were compared for gestational age, 166 were compared with lecithin/sphingomyelin (L/S) ratios, and 56 compared with the FELMA microviscosimeter. Although Pl could be detected by the sixteenth gestational week, PG was not found earlier than the thirty-fifth week. Median L/S ratio in samples not containing PG was 1.94, while PG-positive fluid had a median ratio of 3.72 (p less than 0.001). One hundred twelve infants born within 72 hours were evaluated for outcome. No instance of hyaline membrane disease (HMD) occurred in any neonate with detectable PG regardless of L/S ratio, while 2 of 67 (3%) infants with mature L/S ratios developed HMD. The FELMA technique did not mispredict maturity in any neonate who subsequently developed HMD. Two samples contained PG but the neonates were delivered free of lung disease. The phospholipid lung profile appears to be the most accurate method for the evaluation of fetal lung maturity, while the FELMA technique, although less sensitive, is more rapid.

Amniotic Fluid↗
PubMed1979

Amniotic fluid phosphatidylglycerol and real-time ultrasonic cephalometry.

The fetal biparietal diameter (BPD) was measured at the time of real-time ultrasound-directed amniocentesis in 159 cases and a phospholipid profile was obtained from the amniotic fluid. BPD measurements of 9.0, 8.7, and 9.2 cm were then compared with a lecithin/sphingomyelin (L/S) ratio greater than or equal to 2.0 for the ability to predict the presence of phosphatidylglycerol (PG) in the profile. The data from the diabetic and nondiabetic patients were analyzed separately. The results demonstrated that in the presence of a L/S ratio greater than or equal to 2.0 the BPD does not aid in the identification of amniotic fluid samples which contain PG in either the diabetic or nondiabetic groups. The data also confirmed previous findings that the BPD is not a reliable predictor of the L/S ratio. It is concluded that for the detection of PG in amniotic fluid, the use of real-time ultrasonic cephalometry cannot substitute for the performance of the phospholipid profile.

Amniotic Fluid↗
PubMed1979

Evaluation of the FELMA microviscosimeter in predicting fetal lung maturity.

A new, rapid technique for determining fetal lung maturity, the FELMA, was tested against the standard lecithin/sphingomyelin (L/S) ratio in predicting hyaline membrane disease (HMD). The FELMA was tested on 236 samples, 154 of which were compared with the L/S ratio; 102 neonates were delivered within 48 hours. There was a significant correlation between methods ( r = 0.47). No neonate with a mature FELMA score developed HMD. Of 5 neonates with HMD, 2 had mature L/S ratio in predicting lung immaturity, providing a rapid result without the necessity of thin-layer chromatography.

Amniotic Fluid↗
PubMed1977

Unilateral tuboovarian abscess: a distinct entity.

In a 30 month interval at the Los Angeles County-University of Southern California Medical Center, 85 patients had tuboovarian abscesses removed that were unrelated to complications of pregnancy. Thirty-seven patients (44 per cent) of the 85 had unilateral abscesses. Twenty patients (54 per cent) of the 37 patients with a unilateral abscess were using an intrauterine contraceptive device (IUD). In 13 (65 per cent) of the 20 women using an IUD, the foreign body was a Dalkon Shield. Unilateral pelvic abscesses can occur with or without the presence of an IUD.

Abscess↗