Biomedical subjects

V Berghella

Publications and source records attributed to V Berghella.

26 records · Page 2Linked to original sources

PubMed1997

Cervical funneling: sonographic criteria predictive of preterm delivery.

Our objective was to establish sonographic criteria that are predictive of preterm delivery in patients with internal os dilatation (funneling). The study population consisted of patients with cervical funneling identified on translabial or transvaginal ultrasound examination. Funnel length, functional length, percentage funneling and funnel width were evaluated for their predictive values for preterm delivery. In the 43 patients who met the study criteria, funneling was detected at a mean gestational age of 21.4 weeks (range 16-28). Twenty-three of 31 patients (74%), manually examined immediately following the ultrasound examination, had a closed cervix. Preterm delivery occurred in 42% of patients. Funnel length of > or = 16 mm, functional length of < or = 20 mm, funneling of > or = 40% and funnel width of > or = 14 mm correlated significantly with preterm delivery. Patients with funneling of < 25%, 25-50% and > 50% had preterm delivery rates of 17%, 29% and 79%, respectively.

Adult↗

PubMed1997

Malignant struma ovarii. A case report and review of the literature.

Malignant struma ovarii is a rare form of ovarian carcinoma; only 3 cases of its pure papillary type have been reported in the literature. A new case of malignant papillary struma ovarii arising in an asymptomatic 32-year-old woman is presented. Due to its rarity, there has been confusion in the diagnosis and management of malignant struma ovarii. Criteria for the diagnosis of malignant papillary struma ovarii are proposed. Conservative treatment after a complete staging procedure is possible due to the usually benign course and low incidence of metastases of this tumor.

Adult↗

PubMed1996

Stripping of membranes as a safe method to reduce prolonged pregnancies.

OBJECTIVE: To evaluate weekly stripping of membranes at term to determine its safety and effectiveness in reducing the incidence of prolonged and postterm pregnancies. METHODS: One hundred forty-two pregnant women with certain gestational dates were randomly selected to receive, starting at 38 weeks, either weekly stripping of membranes (73 patients) or weekly gentle cervical examinations (69 patients). RESULTS: Women who received stripping had earlier delivery (8.2 versus 12.2 days; P < .005) and less incidence of delivery at 41 weeks or greater (three versus 13 patients; P < .01). The reduction remained consistent for favorable and unfavorable Bishop scores, and for nulliparas and multiparas. Only three subjects in the study delivered at 42 weeks or greater. No woman reported rupture of membranes after stripping. CONCLUSION: Stripping of membranes is a safe method to reduce the incidence of prolonged pregnancies and the length of term gestations. Larger trials on populations with a higher incidence of postterm pregnancies are needed to evaluate its efficacy in reducing the incidence of postterm pregnancies.

Adult↗

PubMed1996

Prolongation of pregnancy and survival of remaining fetuses after operative evacuation of one triplet at 18 weeks' gestation.

BACKGROUND: Successful delay of aftercoming siblings is an infrequent event in obstetrics. No case of second-trimester operative vaginal evacuation of a fetus followed by delayed delivery of the remaining siblings has been described previously. CASE: A triplet pregnancy was complicated by preterm rupture of membranes at 17 weeks' gestation, followed by cord prolapse and subsequent fetal arm prolapse at 18 weeks' gestation. Operative evacuation of triplet A was performed under ultrasound guidance, with the placenta left undisturbed. Antibiotics and tocolytics were used perioperatively and the pregnancy was prolonged for another 16 weeks. Onset of active labor at 34 weeks' gestation resulted in the vaginal delivery of viable twin males weighing 2810 and 2680 g. CONCLUSION: In cases of multiple gestations with second-trimester rupture of the lower sac, selective fetal evacuation can be performed safely and may allow successful continuation of the remaining pregnancy.

Adult↗

PubMed1996

Does primary omental pregnancy exist?

Omental pregnancy is a rare form of abdominal pregnancy. In the 5 previously reported cases, primary implantation of the embryo to the omentum has been proposed as its etiology. We present a new case of omental pregnancy in a 31-year-old woman presenting with symptoms of ectopic pregnancy. After careful review of our case and the published literature in view of the accepted definition of primary abdominal pregnancy, we conclude that all reported instances of omental pregnancy are secondary and probably follow tubal or ovarian pregnancy abortion.

Abortion, Spontaneous↗

PubMed1996

Pregnancy in patients with preexisting transverse myelitis.

BACKGROUND: Although several cases of pregnancies of traumatic spinal cord injury patients have been reported, to our knowledge, only one case has been reported detailing the perinatal outcome in a patient with preexisting transverse myelitis. CASE: The prenatal course and pregnancy outcome in two patients with preexisting transverse myelitis is presented. The major complications encountered were urinary tract infections and mobility problems. CONCLUSION: Patients with preexisting transverse myelitis can have successful pregnancies with term vaginal deliveries. Prevention of potential complications, such as anemia, preterm labor and delivery, decubitus ulcers, and autonomic dysreflexia can be achieved with coordinated multidisciplinary management.

Adult↗

PubMed1994

Distribution of intraperitoneal chemotherapy into the pleural cavity.

BACKGROUND: Intraperitoneal chemotherapy is an established treatment for abdominal and pelvic malignancies. Several catheter-related complications have been reported. We report a case of abnormal distribution of intraperitoneal chemotherapy into the pleural cavity. CASE: A patient receiving intraperitoneal cisplatin developed shortness of breath. A pleural effusion was diagnosed and was evacuated by thoracentesis. Abnormal distribution of instilled fluid was responsible for her distress. CONCLUSION: Communications exist between the peritoneal and pleural cavities. The use of intraperitoneal chemotherapy or radioactive material may lead to respiratory complications if abnormal distribution occurs.

Antineoplastic Agents↗

PubMedDate not supplied

Accuracy of prenatal diagnosis of congenital heart defects.

OBJECTIVES: (1) To evaluate the detection and accuracy of fetal echocardiography for congenital heart defects (CHD). (2) To compare the detection and accuracy of a team of maternal fetal medicine specialists and radiologists (MFM/R) with those of perinatal cardiologists (PC). METHODS: All fetal echocardiograms performed from 1/91 to 6/95 were reviewed retrospectively. CHD diagnoses made prenatally were compared with postnatally-confirmed diagnoses. RESULTS: 106 heat defects were correctly detected prenatally. There were 10 incorrect diagnoses, 6 false-negatives and 4 false-positives. Overall detection rate (sensitivity) was 95%, while overall accuracy was 87%. Detection rate for MFM/R and PC were 91 and 97%, respectively (p = 0.4). Accuracy was 74% for MFM/R and 92% for PC (p = 0.02). CONCLUSIONS: CHD can be identified reliably by prenatal echocardiography. The involvement of a PC in the prenatal diagnosis of these defects may improve diagnostic accuracy.

False Negative Reactions↗