Publications (10) View all
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Article: Prophylactic maternal N-acetylcysteine in rats prevents maternal inflammation-induced offspring cerebral injury shown on magnetic resonance imaging.
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ABSTRACT: Maternal infection or inflammation may induce fetal inflammatory responses associated with fetal injury and cerebral palsy. We sought to assess the inflammation-associated neuroprotective potential of prophylactic N-acetyl-cysteine (NAC). We examined the effect of NAC on prevention of maternal lipopolysaccharide (LPS)-induced neonatal brain injury using magnetic resonance imaging. Pregnant Sprague Dawley dams (n = 5-8) at embryonic day 18 received intraperitoneal injection of LPS or saline at time 0. Animals were randomized to receive 2 intravenous injections of NAC or saline (time -30 and 120 minutes). Pups were delivered spontaneously and allowed to mature until postnatal day 25. Female offspring were examined by magnetic resonance brain imaging and analyzed using voxel-based analysis after spatial normalization. T2 relaxation time was used to assess white matter injury and diffusion tensor imaging for apparent diffusion coefficient (ADC) to assess white and gray matter injury. Offspring of LPS-treated dams exhibited significantly increased T2 levels and increased ADC levels in white and gray matter (eg, hypothalamus, motor cortex, corpus callosum, thalamus, hippocampus), consistent with diffuse cerebral injury. In contrast, offspring of NAC-treated LPS dams demonstrated similar T2 and ADC levels as control in both white and gray matter. Maternal NAC treatment significantly reduced evidence of neonatal brain injury associated with maternal LPS. These studies suggest that maternal NAC therapy may be effective in human deliveries associated with maternal/fetal inflammation.American journal of obstetrics and gynecology 03/2013; 208(3):213.e1-6. · 3.28 Impact Factor -
Article: Early prenatal diagnosis of tricuspid stenosis.
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ABSTRACT: Although the prenatal diagnosis of heart anomalies has improved dramatically during the last 2 decades, the diagnosis of heart anomalies remains a challenge. Tricuspid stenosis has not been previously diagnosed in the early second trimester. The sonographic signs of early detection of tricuspid stenosis at 15 weeks of gestation included normal sized right atrium, small right ventricle, narrow pulmonary artery, and diminished flow through the tricuspid valve. The diagnosis was confirmed by postabortal examination. In this case report we describe, for the first time, early prenatal diagnosis of tricuspid stenosis at 15 weeks' gestational age.American journal of obstetrics and gynecology 08/2012; · 3.28 Impact Factor -
Article: Doppler studies of the ovarian venous blood flow in the diagnosis of adnexal torsion.
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ABSTRACT: To evaluate the role of ovarian Doppler studies in diagnosing adnexal torsion. We included in that study all patients who had an adnexal mass with clinical symptoms of intermittent lower abdominal pain and were hospitalized for at least 48 hours of observation. Our protocol included: measurements of the size of the adnexal mass, presence or absence of ovarian edema, presence or absence of adnexal vascularity, presence or absence of ovarian artery flow, presence or absence of ovarian venous flow, pattern of ovarian venous flow. The ovarian artery and vein were sampled just above and lateral to the adnexa. Sensitivity, specificity, and positive and negative predictive values in the diagnosis of adnexal torsion were calculated for each of the gray-scale and Doppler sonographic (US) findings. One hundred and ninety-nine patients presented with adnexal mass and intermittent lower abdominal pain. Sensitivity and specificity of tissue edema, absence of intra-ovarian vascularity, absence of arterial flow, and absence or abnormal venous flow in the diagnosis of adnexal torsion were: 21% and 100%, 52% and 91%, 76% and 99%, and 100% and 97%, respectively. All patients with adnexal torsion had absent flow or abnormal flow pattern in the ovarian vein. In 13 patients, the only abnormality was absent or abnormal ovarian venous flow with normal gray-scale US appearance and normal arterial blood flow. Of these 13 patients, 8 (62%) had adnexal torsion or subtorsion. Abnormal ovarian venous flow may be the only abnormal US sign observed during the early stage of adnexal torsion.Journal of Clinical Ultrasound 09/2009; 37(8):436-9. · 0.81 Impact Factor -
Article: Significance of early prenatal diagnosis of fetal hepatic cyst.
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ABSTRACT: : To summarize our experience of early prenatal diagnosis of fetal hepatic cysts. : We reviewed all cases of fetal hepatic cyst detected in our institution between 13 and 17 weeks' gestation over the last 20 years. All scans were initially performed transvaginally to improve image quality. Most of the scans were performed as a routine fetal anatomy scan in a low-risk population. : Seven fetal hepatic cysts were detected out of 54,500 fetal anatomy scans performed between 13 and 17 weeks' gestation. Five peripheral cysts measuring 3-5 mm disappeared during the follow-up period, between 18 and 24 weeks' gestation. Two hilar cysts appeared on sonography as choledochal cysts; one disappeared at 22 weeks' gestation, and the other diminished in size during the postnatal follow-up. : Based on our experience, when hepatic cysts are diagnosed during an early fetal anatomy scan, disappearance of these cysts can be expected, especially when the cysts are initially small and peripheral. (c) 2008 Wiley Periodicals, Inc. J Clin Ultrasound, 2009.Journal of Clinical Ultrasound 02/2009; 37(2):65-8. · 0.81 Impact Factor -
Article: Association between gestational age and induction-to-abortion interval in mid-trimester pregnancy termination using misoprostol.
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ABSTRACT: The study was aimed to evaluate the effectiveness, outcome, and pain intensity of the vaginal administration of misoprostol for the induction of abortion between 13 and 24 gestational weeks. A retrospective study was conducted at our tertiary medical center from January 2006 to December 2009 on 122 consecutive women who underwent termination of pregnancy (TOP) in the mid-trimester. They were given 400 mcg of vaginal misoprostol every 6h, up to four doses. The induction-to-abortion interval and the level of pain experienced during the process were assessed. Success was defined by the fetus being expelled within 48 h. Vaginal misoprostol was effective in 84% (98/122) of patients. The median duration of the induction-to-abortion interval was 16 (5-48)h. The induction-to-abortion interval was correlated with gestational age, while inversely correlated with parity. A correlation was also found between gestational age and pain intensity at 12h from induction. Misoprostol is safe and effective in mid-trimester abortion induction. The induction-to-abortion interval is shorter and abortion less painful with lower gestational age. Higher parity is also associated with shorter induction to abortion interval.European journal of obstetrics, gynecology, and reproductive biology 06/2011; 156(2):140-3. · 1.97 Impact Factor
