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Biomedical subjects

S Karchmer

Publications and source records attributed to S Karchmer.

At least 19 recordsLinked to original sources
PubMed1996

Umbilical cord beta-endorphin and early childhood motor development.

Stress during delivery has been associated with elevated umbilical cord plasma beta-endorphin levels. Published research suggests that much cord beta-endorphin originates from fetal pituitary. Intact pituitary function is required for normal growth and development. Relationships between cord beta-endorphin and child development have not been previously reported. We measured paired maternal and cord plasma beta-endorphin concentration in a set of 106 low risk deliveries by solid phase two-site immunoradiometric assay. Geometric mean maternal and cord beta-endorphin concentrations were 128 pg/ml and 196 pg/ml, respectively, with corresponding ranges of 33-533 pg/ml and 70-579 pg/ml. Cord beta-endorphin concentration was significantly higher than maternal, regardless of delivery mode, and the two were significantly correlated (r = 0.231; P = 0.017). Multiple regression modeling showed that forceps delivery, maternal beta-endorphin concentration, bradycardia, vaginal delivery, and birth weight each made independent contributions to elevated cord beta-endorphin. Depressed cord beta-endorphin predicted more day 2 neurological soft signs, lower 6-month mental development, and lower 36-month motor score on psychometric tests of the children. Poorer fine motor control and coordination were predominantly associated with lower beta-endorphin. Level of cord beta-endorphin independent of delivery stress exerted the primary influence upon child motor development. Higher levels of stress-independent beta-endorphin may play a direct role in motor development.

Child Development↗
PubMed1996

[Systemic lupus erythematosus and pregnancy (analysis of 84 cases)].

We present 84 pregnancies (3 twin pregnancies) of 80 women with Systemic Lupus Erythematosus. Although there was a multidisciplinary prenatal control, in 83% of the cases there were one or more complications during pregnancy, most of them being preterm labor, premature rupture of membranes and preeclampsia-eclampsia. There were flares up in 15 of 84 cases, (17.85%). Worsening of renal function was the most common finding. There were 9 abortions, 3 stillbirths, 1 neonatal death and two newborns with congenital heart block. No maternal deaths were present.

Abortion, Spontaneous↗
PubMed1996

[Ultrastructural analysis of placentas with villitis. Retrospective study].

A villitis is a focal or multifocal inflammatory reaction of chorionic villi with infiltration of mononuclear cells and usually is associated with fibrinoid necrosis. The aetiology of villitis could be a transplacental infection of the fetus, especially with virus (VIV), in normal placentae however, the presence of villitis is referred as villitis of unknown ethiology (VED). This study was designed to characterize villitis lesions of 11 placentae, four VIV and seven VED, ultrastructural descriptive comparisons of both types of villitis are discussed. Biopsies were processed with the conventional optic and electronic microscopy techniques. Our ultrastructural observations confirmed the presence of virus in four placentae whereas no virus or bacteria were found in seven placentae. Microvilli were absent or markedly diminished, this finding was associated to the presence of fibrinoid necrosis in the stroma and clinically to intrauterine growth retardation, 4 preterm pregnancies and one obitus. Trophoblast alterations were found in both types of villitis, basal membrane thickness, is some cases associated to electrodense material similar to calcium deposites, vascuolization and the presence of edema in the stroma was observed. In some cases we noted the presence of focal fibrin deposits associated to necrosis zones in the stroma, calcium precipitates and mielinic bodies. Fetal vessels obliteration and intravascular thrombi were found in the syncitiotrophoblast placentae with viral particles CMV or rubivirus associated to an increment in Hofbauer cells and basal membrane calcifications. From our ultrastructural observations, we conclude that both types of villitis are associated to a typic immunologic reaction that induce lose of trophoblast microvilli, mononuclear infiltration and edema. This placental alterations reduce dramatically the maternofetal exchange of gases, nutrients and other active peptides and could be the cause of fetal growth retardation, inmadurity or death.

Chorionic Villi↗
PubMed1995

[Placenta praevia/accreta and previous cesarean section. Experience of five years at the Mexico National Institute of Perinatalogy].

Two hundred and ten cases with placenta previa, were reviewed (1989-1994). In 37 (17.6%) placenta accreta was present. From accretism cases in 26 (70.2%) only, there was the antecedent of cesarean section. Average age was 31 years; the highest risk group was 35-39 years with 26% of cases of accretism. Average parity was three, in the group of five gestaes, 33.3% developed placenta accreta. In the group without antecedent of cesarean section, accretism risk was 9.4%; with one section was 21.1%, but with two or more cesarean sections, it was 50%. In the presence of placenta previa advanced maternal age, and two or more cesarean sections, placenta accreta risk is high.

Adult↗
PubMed1995

[Placenta praevia. Maternal and perinatal repercussions. Analysis of 170 cases].

One hundred and seventy cases with placenta previa, at Instituto Nacional de Perinatología, from 1989 to 1993, were reviewed. Incidence in our population was 0.62%; average maternal age was 31 years; the greater amount of cases was among nulliparae; in 72% of them there was the antecedent of uterine scar. Ultrasound diagnosis was done in 81% of the patients, and most frequent placental insertion type was the low one in 49%, and in 31%, total, central placenta. The first hemorrhagic episode occurred at a gestational age of 34 weeks. Most frequent complication was threatening pre-term delivery, and ethinyl adrianol was used as uterine inhibitor. All pregnancies were interrupted, via abdominal. Placental accretion was a frequent complication. Hemorrhage during the second half of gestation is one of the main causes of perinatal morbidity-mortality. Frequency of this complication is from 3% to 5%, of all pregnancies in an open population; and when it appears, is one of the most serious urgencies; so its early diagnosis and opportune treatment will diminish maternal and perinatal morbidity-mortality. Etiology is unknown, but diminished endometrial vascularization, at fundus and body, may be the causal factor. There are other predisposing causes as age, advanced maternal age, multiparity, tumours, scars and smoking. The objective of this study, was to analyze maternal and perinatal repercussions, of placenta previa, based on the experience at Instituto Nacional de Perinatología.

Adolescent↗
PubMed1995

[Recurrent abdominal pregnancy. A case report].

It's a report fo a case of recurrent abdominal pregnancy attended at the Instituto Nacional de Perinatologia of México City, the clinical manifestations, diagnosis, and management are described. A review of the literature is presented.

Adult↗
PubMed1994

[Ultrastructural study of placentas from HIV seropositive women].

Eleven placentas from seropositive women for HIV, were analyzed. In three cases the material came from first trimester abortions and the other eight from term pregnancies. In five cases retroviruses were identified, similar to HIV in the placental tissue. It was demonstrated for the first time the internalization of a retrovirus and its presence in the syncytiotrophoblast. It is communicated for the first time the presence of one cell in the placental stroma different to Hofbauer's by its granules type.

Apgar Score↗
PubMed1994

[Hallermann-Streiff syndrome and pregnancy. Report of a case].

The Hallermann-Streiff syndrome is characterized by dyscephaly (bird like facies), microphthalmia, cataracts, micrognathia, beaked nose, abnormal dentition, hypotrichosis, cutaneous atrophy and proportional small stature. There is no sex predilection. Productive capacity has not been studied in these patients. Successful pregnancy is rare. We present a patient with the classical signs associated with pregnancy, the outcome of which was successful. This is the first reported case of Hallermann-Streiff syndrome associated with pregnancy.

Adult↗
PubMed1993

[Ovulation induction with human menopausal gonadotropins in hypothalamic-hypophyseal disfunction].

This is a report on the institutional experience of the use of Human Menopausal Gonadotropins (HMG) in anovulatory women diagnosed as hypothalamic-hypophysiary dysfunction of Group II of WHO with previous failure to chlomifen citrate therapy. In a period of three years 180 patients were gathered with 420 cycle of treatment, obtaining ovulation in 340 cycles (81%). The ovarian hyperstimulation syndrome (OHS) was present in 15 cases (3.5%). There were 115 pregnancies that correspond to 33.8% of oculatory cycles and to 63.8% of the amount of patients. Multiple pregnancy incidence was 10.4%, and the gestational loses rate was 26%; these results are similar to what has been reported in literature. It is concluded that this medication is a good option of treatment for this type of patients, provided that there are the necessary means to expert and adequate surveillance.

Adult↗
PubMed1993

[The intracellular increase of ionized calcium depends on factors present in the blood of patient with preeclampsia].

In previous works our group has demonstrated that intracellular concentration of calcium ionized is greater in patients with pre-eclampsia than in normotense pregnant patients, and that these figures correlate with arterial pressure. Both indicators become normal six weeks after delivery. With the idea of searching the possible participation of soluble factors in the plasma, in increasing free, intracellular calcium, eight pre-eclamptic patients, were studied; the patients were diagnosed by the criteria of the American College of Gynecologists and Obstetricians. As a control group, eight normotense pregnant patients, were included; they were paired by age, chronological and gestational. To measure transmembrane calcium flow, platelets from healthy males, were used. The platelets were incubated during 0, 15, 30 and 60 minutes in sera of pre-eclamptic patients, or of normotensive pregnant patients, marked with Ca. The differences in calcium transportation, were evaluated with variance analysis of Kruskall Wallis. Calcium transportation was greater when the platelets were incubated in pre-eclamptic patients sera, Md = 1.475 +/- 0.311 nanomoles than when were incubated in normotensive women sera, Md = 0.9725 +/- 0.58 nanomoles, p < 0.02. This finding suggests that in pre-eclamptic patients serum, exists some factor that facilitates the entrance of calcium to the cell, that provokes an increase in free calcium concentration, and it participates in the gestational hypertension.

Adult↗
PubMed1992

[Nosocomial infection during puerperium].

Material and methods used to assess the epidemiology of puerperal infection (PI) in the National Institute of Perinatology (Mexico) between 1984 and 1990, are described. We observed that the general rate of PI ranged between 1.6 and 3.1; post-cesarean section posed a higher risk of infection than vaginal partum. Endometritis, associated with cesarean section, was the most frequent form of PI and gram positive flora was the most frequently found etiological agent. In general terms, we found that the rate of PI remained constant through the years of study, even when there was a significant increase in the practice of cesarean operations. Finally, we emphasize the need for the standardization of clinical norms used to assess the epidemiology of infection events. Standard norms will allow health-service institutions to compare results, observe tendencies, predict changes and take preventive actions.

Cesarean Section↗
PubMed1992

[Changes in glucose metabolism during pregnancy: hospital experience].

The clinical heterogeneity of Diabetes Mellitus (DM) is also evident during the gestational period and thus, pregnancy could be complicated by a previously diagnosed DM or by diabetes that is first diagnosed during pregnancy (gestational diabetes or gestational alteration of the oral glucose tolerance test according with the degree of hyperglycemia). Independently of the stage at time of maternal diagnosis, the conceptus is at greater risk (probably since the time of conception) for abortion, genetic malformations, perinatal metabolic complications and death; these risks are apparently directly related with the time at diagnosis, duration and degree of metabolic alteration on the mother (mainly hyperglycemia) and the adaptive mechanisms on the product (hyperinsulinemia). Retrospectively, 412 pregnancies complicated with any type of carbohydrate metabolism alteration were studied in our service. The results demonstrated a high frequency of Gestational diabetes (42.2%) and of type II diabetes (35.9%); there was a good agreement with previous reports regarding the personal and family histories in the patients already known diabetic before pregnancy. The types of obstetric complications were similar to previous reports, but some of them with a greater frequency in our patients, namely hydramnios, toxemia, and urinary tract infection, and ketoacidosis with a minor frequency. We also observed an increased frequency of congenital malformations on the products. On the other hand, the metabolic complications of the newborn were similar to other reports with a slight predominance on the babies of known diabetic mothers prior to gestation.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

[Nosocomial infection in the neonatal period at a third level care center].

Results are presented on epidemiologic surveillance of nosocomial infection of all neonates attended at the Instituto Nacional de Perinatologia throughout 1988-1990, reporting rates of 2.1, 2.9 and 5.5 per 100 discharge for each of the years studied. Data are presented in full by service, showing rates of 4.7, 9.5 and 23.0 per 100 discharge in Neonatal Intensive Care Unit (NICU) and 1.5, 3.2 and 6.7 per 100 discharge for Neonatal Intermediate Care (NIC) for the same three years. With respect to type of infection, septicemia, pneumonia and conjunctivitis come as the most frequent causes of infection and Staphylococcus sp coagulase negative (30%), Staphylococcus aureus (27%) and Escherichia coli (7%) as the prevailing microorganisms in nosocomial infection.

Cross Infection↗
PubMed1992

[Reliability of the pre-labor weight as a reference mark].

Total weight gain during pregnancy has been an anthropometric mean associated with the birth condition. Based on the fact that it is impossible to evaluate every woman in the pregestational period, the referred pregestational weight at week 30 has been evaluated. Such validation was done, comparing the weight gain of a group of women that referred their pregestational weight, with another group who had both weights evaluated. The results suggest, that the women studied, knew and referred correctly the data.

Female↗
PubMed1991

[Prenatal diagnosis in 350 amniocenteses].

Between march 1988 and march 1991, 350 amniocenteses were performed as a part of the prenatal diagnosis program at the Instituto Nacional de Perinatología. Cytogenetic diagnosis was obtained in 348 cases (99.4%). A total of ten abnormal fetal karyotypes (2.9%) were detected: Down's syndrome, (5) Edwards' syndrome, (2) Turner's syndrome, (1) Klinefelter's syndrome (1) and chromosomal instability. (1) In addition, one carrier of a Robertsonian translocation, two balanced carriers of reciprocal translocations and three cases of true mosaicism, were also detected. In the group of patients studied for indications other than risk of chromosomopathy, one female fetus affected by congenital adrenal hyperplasia, was observed. There were two miscarriages, resulting in a post-procedural fetal loss of 0.57%.

Amniocentesis↗
PubMed1991

[Importance of free intracellular calcium in the physiopathology of pre-eclampsia].

Due to the participation of intracellular free calcium in the mechanisms of vascular smooth muscle contraction, and its importance in the physiopathology of essential arterial hypertension, its possible role in pre-eclampsia physiopathology, was investigated as a cellular model, platelets, were use, as they are similar to vascular smooth muscle cells. The study purpose was to investigate if intracellular concentration of ionized calcium is greater in the patients with pre-eclampsia than in normotensive pregnant women, and also, if there exists a correlation between intracellular calcium concentrations and arterial tension, Seven pre-eclamptic patients, diagnosed by the following criteria: arterial tension greater than or equal to 130/90 mmHg, edema and proteinuria, between 20 to 35 years of age, during the third trimester of gestation, without personal nor family antecedents of hypertension; none of them received treatment at the time, were studied. As control group seven normotensive pregnant women, equal by chronologic and gestational age, were included. Intracellular calcium in platelets was measured by Fluo-3-Am, and arterial blood pressure with conventional sphygmomanometer. Intracellular calcium and arterial blood pressure values, were compared, in both groups by Student's t, and analysis of lineal regression between intracellular calcium and mean arterial blood pressure, was done. Intracellular calcium was significantly greater in patients with pre-eclampsia, than the ones in the control group (142 +/- 5.6 vs 110 +/- 14 p less than 0.0001). Mean arterial blood pressure was also significantly greater in patients with pre-eclampsia (114 +/- 5 vs 83 +/- 3 p less than 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗