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Ultrasound in Obstetrics and Gynecology 11/2010; 36(5):645-6. · 3.01 Impact Factor
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Ultrasound in Obstetrics and Gynecology 10/2010; 36(S1):151-152. · 3.01 Impact Factor
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Ultrasound in Obstetrics and Gynecology 10/2010; 36(S1):121. · 3.01 Impact Factor
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ABSTRACT: Absence or congenital anomalies of the parotid glands are associated with significant long-term morbidity. To date there are no published data on ultrasonographic detection of these defects in early pregnancy. We set out to demonstrate and measure the fetal parotid and submandibular salivary glands at 14-16 weeks using transvaginal ultrasound imaging.
During a routine fetal anomaly detection scan in 30 consecutive patients, an attempt was made to examine the fetal parotid and submandibular glands. The fetal head was scanned in transverse sections just below the fetal ears, and the area of the parotid and submandibular glands was inspected. The examination time was not prolonged for the purpose of measuring the salivary glands. The fetal biparietal diameter and the femur length were also documented.
The median gestational age was 15.4 (range, 14.4-16.5) weeks. In all 30 patients examined, at least one pair of parotid and submandibular glands was clearly visualized and measured. In seven patients the parotid and submandibular glands were visualized on both sides. The median length of the parotid gland was 7.5 (range, 5.5-11.5) mm and that of the submandibular gland was 5.4 (range, 3.7-8.5) mm.
The fetal salivary glands can be demonstrated by transvaginal ultrasound imaging at 14-16 weeks of gestation. This is the first reported study presenting the normal values of salivary gland measurements, which may be important in detecting fetuses with congenital absence or other malformations of the glands.
Ultrasound in Obstetrics and Gynecology 04/2010; 35(4):395-7. · 3.01 Impact Factor
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Ultrasound in Obstetrics and Gynecology 10/2009; 34(S1):79-80. · 3.01 Impact Factor
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Ultrasound in Obstetrics and Gynecology 10/2009; 34(S1):179. · 3.01 Impact Factor
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ABSTRACT: To evaluate the accuracy of endometrial volume measurement and 3-dimensional power Doppler analysis (3D-PDA) in the diagnosis of endometrial carcinoma and endometrial hyperplasia in women with post- and peri-menopausal bleeding.
56 women with post-menopausal and 89 with peri-menopausal bleeding were enrolled. All were scheduled for hysteroscopy, dilatation and curettage, endometrial sampling or hysterectomy, and the ultrasound was performed within 24 h before the procedure. Endometrial thickness, endometrial volume, vascularity index (VI), flow index (FI) and vascularity flow index (VFI) were measured. These parameters were compared between the group of women with normal histology (including endometrial polyps) and the pathologic group (carcinoma and hyperplasia with or without atypia).
Ninety women (62%) had normal histology, 26 (17.9%) had an endometrial polyp, 18 (12.5%) hyperplasia and 11 (7.6%) had endometrial carcinoma. Mean endometrial thickness was 11 mm and 15.5 mm in the normal and pathologic groups respectively (p<0.005). The mean endometrial volume was 6.87 cc and 15.5 cc in the two groups respectively (p<0.001). The VI was 2.27% and 2.95% in the two groups respectively (p=0.022). The FI was 18.6 and 23.6 in the two groups respectively (p=0.014). The VFI was 0.68 and 0.89 in the two groups respectively (p=0.018). Using ROC the area under the curve was 0.698, 0.728, 0.621, 0.631, and 0.625 for endometrial thickness, endometrial volume, VI, FI and VFI respectively. The best predictor of endometrial carcinoma was an endometrial volume of 3.56 cc or more (sensitivity 93.1%, specificity 36.2%).
Endometrial volume and 3D-PDA are good diagnostic tools in predicting endometrial carcinoma and hyperplasia in women with post- and peri-menopausal bleeding.
Gynecologic Oncology 08/2007; 106(2):348-53. · 3.89 Impact Factor
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ABSTRACT: Interstitial pregnancy is rare and dangerous variation of ectopic pregnancy. We describe a case of unilateral interstitial viable twin pregnancy treated by selective uterine artery embolization. A 23-year-old women with clinical and ultrasonic diagnosis of viable twin interstitial pregnancy was treated by selective uterine artery embolization after failure of systemic methotrexate treatment. Her serum beta-HCG was undetectable 2 months after the procedure and the ultrasound scan 70 days after embolization showed only multiple echogenic spots in the right uterine cornua. This therapeutic modality seems to be effective for conservative management of interstitial ectopic pregnancy, and as a prophylactic measure before surgical intervention to prevent major bleeding.
Human Reproduction 09/2004; 19(8):1774-7. · 4.47 Impact Factor
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ABSTRACT: To evaluate the efficacy and safety of labor induction by the double balloon device in women with previous cesarean section. Induction of labor was carried out in 37 women with previous cesarean section for various indications. All the inductions of labor were performed using the Atad double balloon device (ARD).
Cervical ripening (Bishop scores above 5) was achieved in 82.3% of the induced women with subsequent vaginal delivery in 78.6% and repeat cesarean section in 22.3%. An important observation of the results was the chances to achieve a vaginal delivery according to the second Bishop score that was recorded 12 hours following the insertion of the device. When the second was above 5 the chances for vaginal delivery were 79.4%. The mean time from removal of the device to delivery was 10.8 hours. No complications were noted using the device.
The double balloon device appears to be a safe and effective method of inducing labor in women with a previous lower segment cesarean section. Wide scale studies and further use of the device for induction of labor in women who have had previous cesarean sections are warranted.
Acta Obstetricia Et Gynecologica Scandinavica 12/2001; 80(11):1041-2. · 1.77 Impact Factor
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ABSTRACT: Obesity, a common condition in developed countries, is recognized as a threat to health.
To describe the distribution of weight in pregnant women and evaluate the influence of obesity on pregnancy outcome in a high parity northern Israeli population.
The study included 887 women who gave birth in the Western Galilee Medical Center during the period August to November 1995. The patients were classified as underweight, normal weight, overweight, or obese according to body mass index. Maternal demographic, obstetric, and perinatal variables were compared. A control group of 167 normal weight women were matched with the obese group for maternal age, parity, and gestational age.
Obese mothers had a higher incidence of gestational diabetes and pregnancy-induced hypertension compared to normal weight mothers (5.4% vs. 1.8%, and 7.2% vs. 0.6% respectively, P < 0.01), a higher rate of labor induction (20.4% vs. 10.2%, P < 0.01), and a higher cesarean section rate (19.6% vs. 10.8%, P < 0.05). There was also a significant difference in the prevalence of macrosomia in the offspring (16.8% vs. 8.4%, P < 0.05).
Obese pregnant women are at high risk for complications during delivery and therefore need careful pre-conception and prenatal counseling, as well as perinatal management.
The Israel Medical Association journal: IMAJ 02/2000; 2(1):10-3. · 1.02 Impact Factor
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ABSTRACT: We describe 1 case of placenta increta and 1 of placenta percreta, both associated with elevated maternal serum creatine kinase concentration. In patients with placenta previa and ultrasonographic findings of an abnormally adherent placenta, an unexplained elevation in maternal serum creatine kinase level should alert the clinician to the possibility of placenta increta or placenta percreta, with an attendant increase in maternal morbidity.
American Journal of Obstetrics and Gynecology 05/1999; 180(4):1039-40. · 3.47 Impact Factor
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Acta Obstetricia Et Gynecologica Scandinavica 10/1997; 76(8):803. · 1.77 Impact Factor
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ABSTRACT: To determine whether a trial of labor is safe in twin pregnancies after one previous cesarean section.
Retrospective analysis of all cases of multiple pregnancies after cesarean section during the years 1970-1993, including twin gestations after one cesarean section.
Forty-six cases of multiple gestations were found, 36 of which were eligible for the study presented herein. Fifteen women (41.7%) were denied trial of labor. Twenty-one women (58.3%) were allowed trial of labor, 17 (80.9%) of whom were delivered vaginally and four (19.1%) by a repeated cesarean section. The group of trial of labor was compared to the group of elective cesarean section. Hospitalization period was 4.4 +/- 1.9 days and 8.0 +/- 2.6 days in the trial of labor group and elective cesarean section group, respectively (p<0.01). Blood transfusions required were 9.5% and 26.6% in both groups, respectively (NS). Puerperal infections were 9.5% in the trial of labor group, compared to 46.6% in the elective cesarean section group (NS). No scar dehiscence occurred in either groups. There were no statistically significant differences in age, parity, gestational age at delivery, mean newborn weight, Apgar score at one and five minutes, Neonatal Intensive Care Unit admission and mean Neonatal Intensive Care Unit stay.
Vaginal delivery in twin gestation after one previous cesarean section may be considered in appropriate cases. A large multicentral randomized prospective study may further confirm this conclusion.
Acta Obstetricia Et Gynecologica Scandinavica 08/1997; 76(7):663-6. · 1.77 Impact Factor
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ABSTRACT: Several in vitro studies reported on increased levels of progesterone secretion from placental tissue. This was not tested in vivo. To study the issue we examined progesterone levels in women presenting with premature labor before treatment, and 24 h and 48 h after beginning ritodrin treatment. A control group consisted of women treated with indomethacin for preterm labor. There were 13 women in the ritodrin group and 12 in the control group. The mean concentration of progesterone in the ritodrin group was 161.7 +/- 74.2, 132 +/- 50.2 and 145 +/- 49.8 ng/ml before treatment, and 24 and 48 h after ritodrin treatment, respectively. The mean progesterone concentration of the group treated with indomethacin was 129 +/- 45.6, 132 +/- 49.5 and 138.6 +/- 53.5 ng/ml before treatment, and 24 and 48 h after treatment, respectively. There were no statistically significant differences between the groups or within each group before and after treatment. Ritodrin treatment does not affect progesterone levels in vivo as demonstrated by in vitro studies.
Gynecologic and Obstetric Investigation 02/1997; 43(1):34-6. · 1.28 Impact Factor
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Acta Obstetricia Et Gynecologica Scandinavica 11/1995; 74(9):756-7. · 1.77 Impact Factor
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ABSTRACT: To evaluate the significance of beta-HCG levels in peritoneal fluid and serum in the diagnosis of ectopic pregnancy. STUDY DESIGN SETTING: Obstetrics and Gynecology department of a regional general hospital.
Sixty-two women who presented with a differential diagnosis of ectopic pregnancy vs. nonviable intrauterine pregnancy.
All patients underwent D & C and culdocentesis. beta-HCG was measured in simultaneously obtained peritoneal fluid (PF) and serum (S), and the PF/S ratio calculated.
Twenty-three patients had an ectopic pregnancy (Group I). All 23 had higher beta-HCG concentrations in the PF than in the serum, with a mean PF/S ratio of 19.1 +/- 16.9. Twenty-four patients had an intrauterine pregnancy (Group II). The beta-HCG levels in the PF and serum were similar (mean PF/S 1.1 +/- 0.2). The difference in PF/S ratio between groups I and II was statistically significant (p < 0.001).
The measurement of beta-HCG in peritoneal fluid and serum is a useful diagnostic tool in differentiating ectopic from intrauterine pregnancy.
Acta Obstetricia Et Gynecologica Scandinavica 03/1995; 74(3):212-5. · 1.77 Impact Factor
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ABSTRACT: Laparoscopic treatment of ectopic pregnancy is gaining wide acceptance. We report a new simple laparoscopic technique involving grasping the tube with forceps and coagulating on both sides of the ectopic pregnancy site, leaving the fertilized ovum in situ. This method is suitable for multiparous women and women who request tubal sterilization. Sixteen patients (mean age 32.6 +/- 4.4 years) were treated by using this method. The mean duration of hospitalization was 1.94 +/- 1.12 days. No complications occurred.
Gynecologic and Obstetric Investigation 02/1995; 40(1):8-10. · 1.28 Impact Factor
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Obstetrical and Gynecological Survey 10/1993; 48(9):635-9. · 2.51 Impact Factor
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ABSTRACT: Eighty-two pregnancies involving a breech first twin were retrospectively analyzed over two study periods during which the cesarean section rates were 20.9 and 94.9%, respectively. The neonatal and maternal morbidity in both study periods was compared. There were no neonatal deaths during either study period and no cases of interlocking twins among patients delivered vaginally. Neonatal morbidity was unrelated to the mode of delivery. The incidence of maternal fever was, however, significantly higher in the cesarean section group compared with the vaginal delivery group (p < 0.001). Our study suggests that vaginal delivery of selected twin gestations with a breech first twin should be an alternative to cesarean delivery.
Gynecologic and Obstetric Investigation 01/1993; 35(1):38-43. · 1.28 Impact Factor
