Intrapartum management of severe fetal airway obstruction
ABSTRACT To review our experience with the planned intrapartum management of fetuses with suspected severe airway obstruction.
Retrospective review of prenatal presentations, intrapartum airway procurement methods, outcomes, and complications.
All cases (N = 11) at our tertiary airway referral institution between 1995 and 2002 were reviewed. Obstruction was secondary to giant cervicofacial lymphangiomas (5), teratomas (2), epignathis (1), epulis (1), conjoined fetus (1), and tracheal foreign body (1). Elective cesarean delivery of the entire fetus was performed while maintaining fetal-placental circulation as long as possible. We found it necessary to deliver the entire fetus to improve airway exposure and decrease maternal hemorrhage. The airway was secured effectively in all cases.
Although full cesarean delivery of the fetus significantly reduces fetal-placental circulation times, in comparison with the formal ex utero intrapartum treatment (EXIT) procedure, airway access is improved, maternal complications may be decreased, and high airway procurement success is still safely achieved.
Conference Paper: Fully-integrated correlated tuning processor for continuous-time filters[Show abstract] [Hide abstract]
ABSTRACT: Measurement results on the correlated tuning loop (CTL), a novel tuning loop for continuous-time filters integrated in a 2 μm CMOS process are presented. Measured performance indicates that a second-order bandpass filter at 2.5 MHz and Q-factor of 10 can be tuned with an error in resonance frequency of only 0.2% and a gain error of only 1.1 dB. The prototype circuit, which measures 4.8 mm<sup>2</sup>, has been designed and optimized specifically to tune a second order bandpass filter at 10 MHz. The CTL approach, however, may be applied to any filter structure in which the attenuation specifications can be translated to specifications of real and imaginary parts of transfer functionsCustom Integrated Circuits Conference, 1990., Proceedings of the IEEE 1990; 06/1990
- Archives of Otolaryngology - Head and Neck Surgery 07/2006; 132(6):686-9. DOI:10.1001/archotol.132.6.686 · 1.75 Impact Factor
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ABSTRACT: Congenital high airway obstruction syndrome (CHAOS) is a rare prenatal diagnosis consisting of a typical fetal triad of large hyperechogenic lungs, flattened or inverted diaphragms and ascites. Most cases are sporadic with unknown incidence. Before attempts of fetoscopic fetal salvage or ex utero intrapartum treatment (EXIT) are considered, additional malformations must be carefully excluded as CHAOS may be part of various monogenic conditions or chromosomal disorders. We report an unique family with autosomal dominant inheritance of CHAOS and variable expression in the affected father and two affected children. It is concluded that minor expression in one of the parents may be an important indicator for genetic counseling in CHAOS and management of future pregnancies.European Journal of Pediatrics 11/2006; 165(10):706-8. DOI:10.1007/s00431-006-0134-z · 1.98 Impact Factor