Congenital portosystemic shunt (CPSS) in a growth‐restricted fetus may lead to cardiac overload a... more Congenital portosystemic shunt (CPSS) in a growth‐restricted fetus may lead to cardiac overload and ultimately hemodynamic imbalance. The aim of the study was to describe the application of tricuspid annular plane systolic excursion (TAPSE) for surveillance of cardiac function in growth‐restricted fetuses diagnosed with CPSS.
Objectives: The osteochondrodysplasias, or skeletal dysplasias are a genetically heterogeneous gr... more Objectives: The osteochondrodysplasias, or skeletal dysplasias are a genetically heterogeneous group. In the 2006 revision of the International Nosology and Classification of Genetic Skeletal Disorders, 372 different conditions were listed in 37 groups defined by such molecular, biochemical, and/or radiographic criteria. Many of them can present in the prenatal period as demonstrated by ultrasound. We report the prenatal diagnosis of skeletal dysplasias in three centers over 5 years period. Methods: Over 21,000 scans in three centers of prenatal diagnosis were made for suspect of skeletal displasya or routinary scan during 2004–08 period. In the most of cases the invasive prenatal diagnosis (chorionic villus sampling/amniocentesis) was performed and the final diagnosis was sought on the basis of fetopathological examination, radiographic studies and molecular testing. Results: A total of 70 antenatal skeletal dysplasias were diagnosed. Follow-up was in all cases, also if the parents decided to stop the pregnancy. The mean gestational age at US diagnosis was 24 wks (12–35 wks). The lethal skeletal dysplasias were diagnosed in the second trimester, instead the diagnosis of limb reduction was possible in the first trimester. Were diagnosed 31 cases of skeletal dysplasia (44,2%), 24 cases of limb reduction (34,2%), arthrogryposis 5 cases (7,1%), amniotic band lesion 5 cases, unexplained skeletal 5 cases (without diagnosis), dysplasia/limb defect 5 cases. A correct antenatal diagnosis was made in 55 cases (78,5%). Conclusion: A specific prenatal diagnosis is not possible in 20/30% of the cases. The diagnosis on the basis of specific pathology is made in a large period of the pregnancy (12–35wks). For an immediate management, assessment of prognosis (95%) is of more value by US plus molecular diagnosis. The definitive diagnosis is made postnatally based on clinical, radiographic, CT criteria and molecular analysis.
IntroductionMaternal glycemic state is positively correlated with fetal insulin secretion. Random... more IntroductionMaternal glycemic state is positively correlated with fetal insulin secretion. Randomized control studies have shown that treatment during pregnancy inhibits to some degree this glycemic effect. Our study aimed to assess fetal pancreas size in a population of treated mothers with gestational diabetes.Material and methodsA cross-sectional, prospective observational study was conducted. Pregnant women at 19–36 weeks of gestation with pre-gestational diabetes receiving insulin therapy or with gestational diabetes receiving either insulin or oral hypoglycemic therapy were recruited. The fetal pancreas circumference was measured and compared to the normal reference range. The Z score of the difference between measured and normal predicted mean pancreas circumference, the regression analysis throughout pregnancy, and the correlation between estimated fetal weight centile and pancreas circumference were calculated.ResultsNinety-one women who had gestational diabetes and thirty-...
The Israel Medical Association journal : IMAJ, 2017
BACKGROUND In recent years, the role of intrapartum sonography has expanded in childbirth managem... more BACKGROUND In recent years, the role of intrapartum sonography has expanded in childbirth management, in subjective clinical situations such as arrested deliveries, or prior to instrumental deliveries. OBJECTIVES To assess the current use of intrapartum ultrasound by obstetricians in Israel. METHODS An anonymous questionnaire was completed by 79 obstetricians in second- and third level- hospitals in Israel. The results were analyzed according to main subspecialty (sonography, delivery), experience and gender. RESULTS A questionnaire was completed by 56 senior obstetricians and 23 interns with an average experience of 14.3 and 2.4 years, respectively. All obstetricians performed ultrasound examinations in the delivery room for basic indications such as fetal presentation during twin delivery and to rule out placenta previa. Sonographers consistently reported advanced indications as compared to senior members of delivery teams and interns in the assessment of prolonged first (52% vs. ...
15th World Congress on Ultrasound in Obstetrics and Gynecology ... P02.14 Rotation of the vermis ... more 15th World Congress on Ultrasound in Obstetrics and Gynecology ... P02.14 Rotation of the vermis in the fetus as a possible etiology for enlarged posterior fossa Y. Zalel1, YG Gilboa1, LG Gabis2, LB Ben-Sira3, RA Achiron1 1Department of Obstetrics & Gynecology, The Chaim-...
Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine, 2011
The purpose of this study was to establish in utero reference ranges for the fetal umbilical cord... more The purpose of this study was to establish in utero reference ranges for the fetal umbilical cord insertion-to-genital tubercle length in early gestation. A prospective cross-sectional study was performed on 140 normal low-risk singleton pregnancies between 12 and 18 weeks' gestation. The umbilical cord insertion-to-genital tubercle length was measured in a midsagittal section with high-resolution transvaginal or transabdominal sonography. The mean and 95% prediction limits were defined for each gestational week and analyzed by regression equations and correlation coefficients. Adequate measurements were obtained in 134 patients. The umbilical cord insertion-to-genital tubercle length as a function of gestational age was expressed by the following regression equation: umbilical cord insertion-to-genital tubercle length = -3.079452 + 1.09 × week (R(2) = 0.7117). The correlation R(2) = 0.7117 was found to be highly statistically significant (P < .001). The normal mean and 95% p...
Congenital portosystemic shunt (CPSS) in a growth‐restricted fetus may lead to cardiac overload a... more Congenital portosystemic shunt (CPSS) in a growth‐restricted fetus may lead to cardiac overload and ultimately hemodynamic imbalance. The aim of the study was to describe the application of tricuspid annular plane systolic excursion (TAPSE) for surveillance of cardiac function in growth‐restricted fetuses diagnosed with CPSS.
Objectives: The osteochondrodysplasias, or skeletal dysplasias are a genetically heterogeneous gr... more Objectives: The osteochondrodysplasias, or skeletal dysplasias are a genetically heterogeneous group. In the 2006 revision of the International Nosology and Classification of Genetic Skeletal Disorders, 372 different conditions were listed in 37 groups defined by such molecular, biochemical, and/or radiographic criteria. Many of them can present in the prenatal period as demonstrated by ultrasound. We report the prenatal diagnosis of skeletal dysplasias in three centers over 5 years period. Methods: Over 21,000 scans in three centers of prenatal diagnosis were made for suspect of skeletal displasya or routinary scan during 2004–08 period. In the most of cases the invasive prenatal diagnosis (chorionic villus sampling/amniocentesis) was performed and the final diagnosis was sought on the basis of fetopathological examination, radiographic studies and molecular testing. Results: A total of 70 antenatal skeletal dysplasias were diagnosed. Follow-up was in all cases, also if the parents decided to stop the pregnancy. The mean gestational age at US diagnosis was 24 wks (12–35 wks). The lethal skeletal dysplasias were diagnosed in the second trimester, instead the diagnosis of limb reduction was possible in the first trimester. Were diagnosed 31 cases of skeletal dysplasia (44,2%), 24 cases of limb reduction (34,2%), arthrogryposis 5 cases (7,1%), amniotic band lesion 5 cases, unexplained skeletal 5 cases (without diagnosis), dysplasia/limb defect 5 cases. A correct antenatal diagnosis was made in 55 cases (78,5%). Conclusion: A specific prenatal diagnosis is not possible in 20/30% of the cases. The diagnosis on the basis of specific pathology is made in a large period of the pregnancy (12–35wks). For an immediate management, assessment of prognosis (95%) is of more value by US plus molecular diagnosis. The definitive diagnosis is made postnatally based on clinical, radiographic, CT criteria and molecular analysis.
IntroductionMaternal glycemic state is positively correlated with fetal insulin secretion. Random... more IntroductionMaternal glycemic state is positively correlated with fetal insulin secretion. Randomized control studies have shown that treatment during pregnancy inhibits to some degree this glycemic effect. Our study aimed to assess fetal pancreas size in a population of treated mothers with gestational diabetes.Material and methodsA cross-sectional, prospective observational study was conducted. Pregnant women at 19–36 weeks of gestation with pre-gestational diabetes receiving insulin therapy or with gestational diabetes receiving either insulin or oral hypoglycemic therapy were recruited. The fetal pancreas circumference was measured and compared to the normal reference range. The Z score of the difference between measured and normal predicted mean pancreas circumference, the regression analysis throughout pregnancy, and the correlation between estimated fetal weight centile and pancreas circumference were calculated.ResultsNinety-one women who had gestational diabetes and thirty-...
The Israel Medical Association journal : IMAJ, 2017
BACKGROUND In recent years, the role of intrapartum sonography has expanded in childbirth managem... more BACKGROUND In recent years, the role of intrapartum sonography has expanded in childbirth management, in subjective clinical situations such as arrested deliveries, or prior to instrumental deliveries. OBJECTIVES To assess the current use of intrapartum ultrasound by obstetricians in Israel. METHODS An anonymous questionnaire was completed by 79 obstetricians in second- and third level- hospitals in Israel. The results were analyzed according to main subspecialty (sonography, delivery), experience and gender. RESULTS A questionnaire was completed by 56 senior obstetricians and 23 interns with an average experience of 14.3 and 2.4 years, respectively. All obstetricians performed ultrasound examinations in the delivery room for basic indications such as fetal presentation during twin delivery and to rule out placenta previa. Sonographers consistently reported advanced indications as compared to senior members of delivery teams and interns in the assessment of prolonged first (52% vs. ...
15th World Congress on Ultrasound in Obstetrics and Gynecology ... P02.14 Rotation of the vermis ... more 15th World Congress on Ultrasound in Obstetrics and Gynecology ... P02.14 Rotation of the vermis in the fetus as a possible etiology for enlarged posterior fossa Y. Zalel1, YG Gilboa1, LG Gabis2, LB Ben-Sira3, RA Achiron1 1Department of Obstetrics & Gynecology, The Chaim-...
Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine, 2011
The purpose of this study was to establish in utero reference ranges for the fetal umbilical cord... more The purpose of this study was to establish in utero reference ranges for the fetal umbilical cord insertion-to-genital tubercle length in early gestation. A prospective cross-sectional study was performed on 140 normal low-risk singleton pregnancies between 12 and 18 weeks' gestation. The umbilical cord insertion-to-genital tubercle length was measured in a midsagittal section with high-resolution transvaginal or transabdominal sonography. The mean and 95% prediction limits were defined for each gestational week and analyzed by regression equations and correlation coefficients. Adequate measurements were obtained in 134 patients. The umbilical cord insertion-to-genital tubercle length as a function of gestational age was expressed by the following regression equation: umbilical cord insertion-to-genital tubercle length = -3.079452 + 1.09 × week (R(2) = 0.7117). The correlation R(2) = 0.7117 was found to be highly statistically significant (P < .001). The normal mean and 95% p...
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