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V Catanzarite

Publications and source records attributed to V Catanzarite.

At least 19 recordsLinked to original sources
PubMed2005

Targeted mid-trimester ultrasound examination: how does fetal anatomic visualization depend upon the duration of the scan?

OBJECTIVE: To determine the relationship between visualization of key fetal anatomic structures during mid-trimester ultrasound examination with gestational age and duration of examination. METHODS: One hundred ultrasound examinations at 16-22 weeks' gestation were reviewed to determine the times at which key fetal anatomic features were seen. Scans were terminated at 30 min or when a comprehensive anatomic survey was complete. Exclusion criteria included multiple gestation, maternal weight>77 kg, abdominal wall scarring, and suspected fetal anomalies. RESULTS: Visualization of cranial anatomy including lips, face, midline, ventricles, choroid plexus, and cerebellum was achieved in 98% of patients within 30 min. The corresponding figures for spine, cardiac screening (four-chamber, aortic, and pulmonary outflow views) and for abdominal anatomy (stomach, kidneys, bladder, ventral wall, and three-vessel cord) were 91%, 91%, and 99%, respectively. A complete anatomic survey including each of the above elements was obtained by 10, 15, 20, 25, and 30 min in 8%, 31%, 53%, 72% and 81% of the subjects. Rates of complete anatomic surveys within 30 min improved by gestational age interval, from 20/30 (67%) at 16-18 weeks, to 36/44 (82%) at 18-20 weeks, and 25/26 (96%) at 20-22 weeks; this rise was primarily due to improvements in visualization of the spine and heart. CONCLUSIONS: A comprehensive anatomical survey can be completed in 10 min or less in a minority of patients. For each 5-min time increment up to 30 min, the rate of complete surveys improves. Rates of completed anatomic surveys rise with gestational age.

Aortic Valve↗
PubMed2001

Acute respiratory distress syndrome in pregnancy and the puerperium: causes, courses, and outcomes.

OBJECTIVE: To describe causes, courses, complications, and outcomes of patients with pregnancy-associated acute respiratory distress syndrome (RDS). METHODS: Twenty-eight women with ARDS during pregnancy or within a week postpartum formed the study population. Eight cases had been reported previously. Charts were abstracted for maternal demographics, etiology, and treatment of acute RDS, and maternal outcomes. For antepartum acute RDS, newborn charts were also reviewed. RESULTS: The incidence of acute RDS, excluding maternal transports, was one per 6277 deliveries or 0.016% (95% confidence interval [CI] 0, 0.027%). Leading causes were infection (12 cases), preeclampsia or eclampsia (seven cases), and aspiration (three cases). Eleven mothers died, a maternal mortality rate of 39.3% (CI 21.5%, 59.4%). Six of eight women who were ventilated for over 14 days survived. Nine of the acute RDS cases might have been preventable. Ten mothers with living fetuses were ventilated during the third trimester; nine delivered within 4 days. Among six infants delivered because of fetal heart rate abnormalities, one died and at least three had evidence of asphyxia. CONCLUSIONS: Acute RDS occurs more frequently in pregnancy than the 1.5 cases per 100,000 per year reported for the general population. Prolonged ventilator support is warranted. The high rate of perinatal asphyxia in infants who have fetal heart rate abnormalities supports a strategy of expeditious delivery during the third trimester.

Adolescent↗
PubMed2001

Prenatal sonographic diagnosis of vasa previa: ultrasound findings and obstetric outcome in ten cases.

OBJECTIVE: To assess the specificity of sonographic diagnosis of vasa previa and pregnancy outcome in sonographically diagnosed cases. METHODS: We prospectively collected cases of vasa previa diagnosed by color Doppler sonography. Delivery by elective Cesarean section after demonstration of fetal pulmonary maturity and prior to the onset of labor was recommended unless obstetric complications supervened. Data regarding maternal obstetric courses and newborn status were collected. RESULTS: Eleven cases of vasa previa without placenta previa were diagnosed among 33 208 women over an 8-year period. Ten patients had confirmation of the diagnosis by the delivering obstetrician and/or placental examination, giving a specificity of diagnosis of 91%. Among the 10 patients with confirmed vasa previa, two were delivered at 31.5 and 35.5 weeks' gestation prior to demonstration of lung maturity, and the remainder were delivered at 34-37.5 weeks, after lung maturity. All infants had normal Apgar scores and survived. One baby had Scimitar syndrome, which was not suspected from sonography. CONCLUSIONS: The specificity of sonographic diagnosis of vasa previa at our center was 91%. Antenatal diagnosis permitted us to prevent the catastrophic outcomes commonly associated with vasa previa.

Adult↗
PubMed1999

Pre-term and particularly pre-labor cesarean section to avoid complications of gastroschisis.

The marked advantages and merit of pre-term and particularly pre-labor (PTPL) cesarean section (C-section) in the avoidance, and indeed, virtual elimination of severely disabling gastroschisis (GS) complications in infants diagnosed prior to birth by ultrasound has unfortunately remained controversial in the 10 to 12 years since it was first reported and strongly recommended by numerous authors. During this period, GS has remained one of the four major causes of the short-gut syndrome (SGS) in infancy and childhood and a major cause of prolonged, costly, complicated, and hazardous neonatal intensive care unit stays with requirements for total parenteral nutrition (TPN). The most serious and frequent complications of GS in infants born without PTPL C-section are the occurrence of the "peel", which greatly enlarges and rigidifies the eviscerated gut, and of "complicated GS" (intestinal atresia/s, stenosis, necrosis, perforations) (CGS). The "peel" occurs in 100% of these cases and CGS in approximately 20%. "Peel" enlargement and rigidification of eviscerated intestine in the presence of a reduced peritoneal cavity causes great difficulty in covering the eviscerated, enlarged, and rigidified gut with abdominal wall, skin, a prosthesis, etc., and frequently produces gut ischemia from excessive pressure, which may lead to necrotizing enterocolitis (NEC) and SGS as well as prolonged hospital stays. The presence of a "peel" greatly complicates the hazards of dealing with cases of CGS, as resection and anastomosis are virtually impossible in the presence of a "peel." The authors report personal experience with 77 cases of GS dating as far back as 1951; 44 of the infants were born after the onset of labor by vaginal or C-section delivery and all had some degree of "peel" formation. Of 320 cases from the literature (including some of the cases reported here), 61 (19.1%) involved CGS. Of the 33 cases born PT, and especially PL, there were no cases of "peel" and only 1 case of CGS (3.0%). This infant had a single atresia associated with a very small (1 cm) defect in the abdominal wall and no labor-induced "peel," which was easily and successfully repaired by resection and anastomosis. The 6.4-fold reduction in the occurrence of CGS by PTPL C-section (3.0% vs 19.1%) was statistically significant by the chi-square test (P < 0.05), as was the 100% elimination of the disabling "peel." If the single case of CGS associated with a very small defect and no labor or labor-associated "peel" is eliminated, the incidence of CGS in the remaining PTPL group of 32 cases falls to 0 (0% versus 19.1%, P < 0.007). PT and especially PL C-section may be expected to virtually eliminate "peel" formation and CGS and to remove GS as one of the four major causes of SGS. The findings of this report that PT labor prior to PT C-section may result in both "peel" formation and CGS further solidifies the role of labor in the production of both the "peel" and the equally disabling CGS. Failure to appreciate the central role of labor in GS complications has doubtless contributed to the persistent controversy concerning the value and importance of PTPL C-section for gastroschisis diagnosed in utero. The pediatric surgeon has an important responsibility with the obstetrician to monitor the possible occurrence of occult labor in the waning weeks of pregnancy and be prepared to do a prompt C-section if it occurs and there is adequate lung maturity. The achievement of "peel"- and CGS-free gut would greatly facilitate the use of the new Bianchi technique of gut reduction without anesthesia. The combination of the use of epidural anesthesia for the elective PTPL C-section with the Bianchi approach would spare both mother and baby any untoward effects of general anesthesia and present the potential for massive reductions in hospital costs with minimal patient manipulation and disturbance. For infants born with labor-associated "peel," re-evaluation of the suitability and effectiv

Cesarean Section↗
PubMed1994

Early sonographic diagnosis of intrapericardial teratoma.

An intrapericardial teratoma associated with a large pleural effusion and elevated aortic outflow velocity was diagnosed at 23.6 weeks' gestation. Less than 4 weeks earlier, an obstetric scan, including a four-chamber heart view, had been normal. In less than a week following diagnosis, fetal hydrops and bradycardia developed. 'Heroic' pericardiocentesis was declined by the patient, and the fetus died. This case demonstrates the potential for rapid growth in pericardial teratomas, and illustrates the possibility of anticipating fetal compromise from tumor mass effect, when intracardiac Doppler studies are abnormal. Implications for management of these rare tumors, and specifically for the hypothetical role of fetal surgery, are discussed.

Journal Article↗
PubMed1994

Overwhelming maternal sepsis due to a gas-forming Escherichia coli chorioamnionitis.

We report a case of a patient who developed fulminant sepsis and respiratory distress caused by a gas-forming Escherichia coli intrauterine infection following premature rupture of the membranes and fetal death. Such gas-forming infections are rare, and, when they occur, they are usually caused by Clostridium welchii. This patient was treated with antibiotics, ventilator support, and hysterectomy, and at follow-up was in good health.

Adult↗
PubMed1993

Prenatal diagnosis of congenital cytomegalovirus infection: false-negative amniocentesis at 20 weeks' gestation.

Cytomegalovirus (CMV) is the most common cause of congenital infection. Recent studies show amniocentesis to be a 100 per cent sensitive and 100 per cent specific predictor of congenital infection, and recommend that it be offered in the at-risk pregnancy. However, these publications have focused on pregnancies at or beyond 22 weeks' gestation. Here, we report a case of maternal CMV hepatitis at 7-8 weeks' gestation, in which culture and polymerase chain reaction testing for CMV in amniotic fluid at 20 weeks' gestation were negative, but the infant had a positive CMV urine culture shortly after delivery. Implications for the prenatal diagnosis of CMV infection are discussed.

Adult↗
PubMed1993

Prenatal diagnosis of a giant intracranial teratoma associated with pulmonary hypoplasia.

We present a case in which an intracranial tumour replacing all intracranial contents was diagnosed by sonography at 31 weeks' gestation. The patient was delivered by caesarean section and died shortly after delivery. At necropsy, the tumour was found to be a teratoma with no recognisable normal brain tissue present. Additional findings at necropsy included pulmonary and adrenal hypoplasia. The diagnosis and prognosis of intracranial teratomas diagnosed in utero, and the association of this tumour with pulmonary hypoplasia, are discussed.

Abnormalities, Multiple↗
PubMed1992

Early prenatal diagnosis of type II cystic adenomatoid malformation of the lung: sonographic and histological findings.

Cystic adenomatoid malformation is a rare abnormality of the fetal lung. Depending on the size and histology of the cyst, it is classified as type I, II or III. With improving ultrasound technology, prenatal diagnosis during the mid-trimester is now possible; however, the earliest previous reports of type II cases have been at 23-24 weeks' gestation. We here report cases diagnosed at 19.5 and 20.5 weeks. In contrast to the appearance of multiple small cysts seen later in pregnancy, these cases showed a predominance of marked hyperechogenicity, usually associated with type III malformations, with small areas of lung involved by sonographically detectable cysts. Both families chose pregnancy termination. Sonographic findings, counselling, and histology are presented and discussed.

Journal Article↗
PubMed1991

The N-terminal and C-terminal portions of the atrial natriuretic factor prohormone increase during preeclampsia.

The influence of preeclampsia on the circulating concentrations of the 28-amino-acid carboxy terminus (C-terminus) (i.e., atrial natriuretic factor) and the amino terminus (N-terminus) of the 126-amino-acid atrial natriuretic factor prohormone (pro ANF) was studied in the third trimester with the use of three specific radioimmunoassays that recognize: (1) atrial natriuretic factor (i.e., amino acids 99 to 126), (2) the whole 98-amino-acid N-terminus, and (3) amino acids 31 to 67 from the midportion of the N-terminus of the prohormone. The C-terminus was significantly increased (p less than 0.001) in the third trimester in women with preeclampsia, the mean +/- SEM of 15 subjects was 150 +/- 7 pg/ml versus 89 +/- 7 pg/ml in the third trimester in 12 women during normal pregnancies and 65 +/- 2 pg/ml in 19 healthy nonpregnant women. The whole 98-amino-acid N-terminus, likewise, was significantly increased (p less than 0.001) in women with preeclampsia to 4706 +/- 629 pg/ml versus 2160 +/- 79 pg/ml in women in the third trimester of normal pregnancies and versus the circulating concentration of 1847 +/- 127 pg/ml in healthy nonpregnant women. ProANF 31 to 67 mean circulating concentration in preeclampsia was 4638 +/- 725 pg/ml, which was also significantly (p less than 0.001) increased compared with its mean circulating concentration in the third trimester of normal pregnancy of 1758 +/- 83 pg/ml or that in healthy nonpregnant women (1400 +/- 105 pg/ml). The circulating concentrations of both the N-terminus and C-terminus of the atrial natriuretic factor prohormone decreased within 24 hours after delivery in contrast to a normal pregnancy in which they both increase post partum. These results indicate a marked difference in the metabolism of both the N-terminus and the C-terminus of the atrial natriuretic factor prohormone in women with preeclampsia versus that in women with normal pregnancies or that in healthy nonpregnant women.

Adolescent↗
PubMed1991

How do perinatologists manage preeclampsia?

The members of the Society of Perinatal Obstetricians were surveyed regarding management of preeclampsia, with focus on drug therapy, use of invasive monitors, and both general policies and treatment of hypothetical cases of preterm severe preeclampsia. There was agreement that magnesium sulfate should be given to all patients with preeclampsia during labor and postpartum and that blood pressure should be held to about 160/105 mmHg. The drugs of choice for control of blood pressure were hydralazine, alpha-methyldopamine, and cardioselective beta-blockers. Most perinatologists use invasive monitors only for specific indications, but a substantial minority use either arterial lines or central venous pressure monitors routinely in severe preeclampsia. There was no consensus with respect to management of preterm, severe preeclampsia, but even among the 49% of respondents who volunteered an unequivocal policy of "deliver regardless of gestational age," over three fourths would hospitalize and observe in selected cases meeting American College of Obstetrics and Gynecology criteria for severe preeclampsia.

Adrenergic beta-Antagonists↗
PubMed1990

Second-trimester ultrasonography: determinants of visualization of fetal anatomic structures.

Little information has been published regarding rates of visualization of fetal anatomic structures or factors affecting visualization in unselected patients. We prospectively studied these points by scoring visualization of intracranial, spinal, cardiac, ventral wall, umbilical cord, stomach, bladder, and genital anatomy in 573 consecutive midtrimester scans in which no fetal anomalies were seen. Each feature was scored 0, 1, or 2, corresponding to poor, adequate, or optimal visualization, and these eight numbers were summed for an overall visualization score. Overall visualization fell abruptly beyond maternal weight 165 pounds (p less than 0.001) and rose with advancing gestational age (p less than 0.001). Placental location did not significantly influence visualization. Overall, an adequate screening scan, defined as adequate visualization of central nervous system, heart, stomach, ventral wall, bladder, and cord was obtained in 51% of scans, and optimal visualization of each of these in only 9% of cases. Factors that might improve anatomic visualization and the implications of these results for the use of ultrasonography in screening for congenital anomalies are discussed.

Amniocentesis↗
PubMed1990

Increase in the plasma levels of the N-terminal and C-terminal portions of the prohormone of atrial natriuretic factor during normal pregnancy.

The influence of pregnancy on the circulating concentrations of atrial natriuretic factor, the 28 amino acid carboxy (C)-terminal end of the 126 amino acid atrial natriuretic factor prohormone, and the amino (N)-terminus of the prohormone was studied with three specific radioimmunoassays recognizing: (1) atrial natriuretic factor (i.e., amino acids 99 through 126), (2) the 98 amino acid N-terminus, and (3) amino acids 31 through 67 from the midportion of the N-terminus of the prohormone. Plasma atrial natriuretic factor in normal pregnant women gradually increased as pregnancy progressed, with the mean +/- SEM being 58 +/- 4 pg/ml in the first trimester, 74 +/- 5 pg/ml in the second trimester, and 89 +/- 7 pg/ml in the third trimester. Likewise, proatrial natriuretic factor 31 through 67 increased from 1421 +/- 76 pg/ml (first trimester) to 1509 +/- 84 pg/ml (second trimester) to 1758 +/- 83 pg/ml in the third trimester, whereas the whole N-terminus of the prohormone increased from 1804 +/- 98 pg/ml (first trimester) to 1909 +/- 111 pg/ml (second trimester) to 2160 +/- 79 pg/ml in the third trimester. These results suggest that release of the N-terminus of the prohormone, as well as atrial natriuretic factor, increases with the rise in blood volume associated with a normal pregnancy. The circulating concentrations of both the C-terminus and N-terminus of the atrial natriuretic factor prohormone increased further in the 48 hours after delivery. Because both the C-terminus and N-terminus of the atrial natriuretic factor prohormone contain diuresis-producing peptides, these results suggest that postpartum diuresis may be mediated by these peptides.

Analysis of Variance↗
PubMed1990

A comparison of attitudes and practices of episiotomy among obstetrical practitioners in New Mexico.

The routine use of episiotomy is a subject of considerable controversy. To delineate attitudes and practices, we surveyed various groups of obstetrical practitioners in New Mexico. Routine use was favored most by obstetricians, less by family practitioners, less yet by nurse midwives and least by lay midwives. Many of the reasons given both for and against routine use were the same, underscoring the lack of scientific data and prospective studies of episiotomy and its effects.

Adult↗