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Y Zalel

Publications and source records attributed to Y Zalel.

99 records · Page 6Linked to original sources
PubMed1991

Ectopic pregnancy: sonographically-guided transvaginal reduction.

The advanced modalities of vaginal ultrasonography and sensitive human chorionic gonadotropin assays have greatly facilitated the diagnosis of early ectopic pregnancy. The treatment spectrum for ectopic pregnancy ranges from a variety of conservative operative measures, including salpingectomy and operative laparoscopy, to various medical regimens or simply watchful observation alone. We report 12 cases in which the ectopic gestation was treated by transvaginal instillation of potassium chloride or methotrexate under sonographic guidance. Three of these, one of two patients receiving potassium chloride and two of six patients receiving methotrexate, later required a laparotomy. The level of beta-subunit of human chorionic gonadotropin was found to be unreliable in predicting the outcome in these patients. Ultrasound follow-up is mandatory. A protocol for treatment is presented.

Journal Article↗
PubMed1991

Cesarean delivery of the second twin after the vaginal birth of the first twin: misfortune or mismanagement?

The perinatal characteristics of 16 vaginal-abdominal deliveries of twins were evaluated. The primary indication for the cesarean delivery was compound vertex presentation (n = 4), prolapsed umbilical cord (n = 4), transverse lie (n = 7), and mentoposterior face presentation (n = 1). Ther outcome of Twin A was not different from that of Twin B. About 90% of the twins were eventually discharged on time. A significant correlation (R = 0.9722, p less than 0.0003) was found between the reported rates of combined deliveries and cesareans in twins. The data suggest that a higher rate of combined deliveries is expected in practices where abdominal deliveries are performed more often in twin gestations, while in obstetric services with low cesarean rates in twins, combined deliveries seem to be unfortunate occurrences dictated by unexpected intrapartum events.

Adult↗
PubMed1990

[Ultrasonically-guided aspiration of clear pelvic cysts].

In 33 women aged 13-80, clear pelvic cysts were aspirated. The diameter of the cysts was between 4-11 cm and the aspiration, by either the vaginal or abdominal routes, was ultrasonically guided. In 25 cases (76%) there was no recurrence of a cyst during continuing follow-up. In 8 cases in which a cyst recurred, 4 were operated on and benign tumors were found. Ultrasonically guided aspiration is appropriate treatment for clear pelvic cysts.

Adolescent↗
PubMed1990

Ritodrine treatment for uterine hyperactivity during the active phase of labor.

Forty consecutive patients with uterine hyperactivity, defined as either tachysystole and/or hypertonus during the active phase of vertex delivery, were treated with intravenous ritodrine (50 up to 300 micrograms/min, in 50 micrograms increments/5 min). Thirty-four patients (85%) responded within 20 min with termination of the uterine dysfunction and all (21, 52%) concomitant fetal heart rate distress signs disappeared. The treatment did not prolong labor, as this was significantly correlated to parity and cervical dilation when treatment was initiated (P less than 0.0006 and P less than 0.008, respectively). Fifteen patients were delivered by cesarean section (37.5%) mainly for cephalopelvic disproportion. Multiparas were older and had shorter ritodrine initiation-delivery intervals, but these were the only significant differences when compared to primiparas. Ritodrine is therefore suggested as an effective treatment of uterine hypercontractility dysfunction.

Adult↗
PubMed1988

Ritodrine-induced pulmonary edema unmasking underlying peripartum cardiomyopathy.

Pulmonary edema was induced by an increase in the dose of ritodrine in a patient receiving the drug for 28 days because of preterm contractions. After initial therapy, the cardiologic evaluation revealed peripartum cardiomyopathy. This is the first report of ritodrine causing pulmonary edema by unmasking underlying asymptomatic cardiomyopathy. This may have been the cause of some of the previously reported cases of ritodrine-induced heart failure.

Adult↗
PubMed1988

Management of labor with umbilical cord prolapse: a 5-year study.

Fifty-one cases of cord prolapse, in which delivery was not imminent and the fetus was still alive, were managed by filling the bladder with 500-700 mL of saline and by intravenous ritodrine. Delivery was by cesarean section as soon as possible. Among the cases so managed, there were no perinatal deaths. The mean 5-minute Apgar score was 9.5, and in only three cases was it less than 7. In eight cases, fetal distress continued after treatment, as compared with 33 cases before this type of treatment started (P less than .001); no difference was found in the outcome between neonates weighing less than or greater than 2500 g.

Administration, Intravesical↗
PubMed1982

The beneficial effect of vacuum extraction of the fetus.

The vacuum extractor (VE) was applied electively after approximately 25 min of expulsion in 25 normal primiparae. Twenty-five identical parturients with spontaneous deliveries served as controls. The fetal scalp pH was measured at the beginning of the 2nd stage, and again in the cord blood of all newborns. Cardiac monitoring by scalp electrode was done for all fetuses throughout labor. The mean pH of the first blood sample was almost identical in the two groups, while the mean decrease in pH in the VE group was 0.077, against a mean change of 0.106 in the controls (p less than 0.05). In the FHR graph the total area of deceleration, and separately in the controls (p less than 0.05). In the FHR graph the total area of deceleration, and separately the up to 30 beats/min (area A) and of more than 30 beats/min (area B) were calculated. The mean total area of deceleration in the VE group was 14.76 cm2vis-à-vis 17.56 cm2 in the controls. Areas A and B were also smaller in the study group, but these differences were not statistically significant. The mean total deceleration time in the VE fetuses was 22.8 min, and 37.75 min in the controls (p less than 0.001). It is concluded that the application of the VE during the second stage lessens fetal depression, when compared with spontaneous delivery.

Extraction, Obstetrical↗