Discordant Twin Pregnancy with One Malformed Fetus – Color Doppler Follow Up for Expectant Management

2011 ◽  
Vol 3 (9) ◽  
pp. 469-472
Author(s):  
Ishan Kumar ◽  
◽  
Shivi Jain Shivi Jain ◽  
Ashish Verma ◽  
Madhu Jain Madhu Jain ◽  
...  
Keyword(s):  
Twin Pregnancy ◽  
Color Doppler ◽  
Expectant Management ◽  
Discordant Twin

The Definition, Diagnosis, and Management of Growth-Discordant Twins: An International Census Survey

1991 ◽  
Vol 40 (3-4) ◽  
pp. 345-351 ◽  
Author(s):  
I. Blickstein
Keyword(s):  
Stress Testing ◽  
Expectant Management ◽  
Doppler Velocimetry ◽  
Diagnosis And Management ◽  
Clear Cut ◽  
Biophysical Profile ◽  
Per Se ◽  
Discordant Twins ◽  
Discordant Twin

AbstractIn order to establish a protocol considering the definition, diagnosis, and management of growth-discordant twin gestations, a questionnaire was sent to 96 authors of twin-related obstetric articles. The views of the 61 responders comprise this international census survey. The data suggest that a clear cut-off value for discordancy is still needed; however, the data indirectly supported a two-grade definition, namely, mild (> 15% and < 25% birth-weight disparity) and severe (> 25%) growth discordants. Expectant management was advocated by the majority of participants with out-patient follow-up for mild discordants, while severe discordants may preferably be hospitalized. Follow-up should be done by non-stress testing (daily - 2/wk), biophysical profile (1-2/wk), Doppler velocimetry (1/wk - bi-weekly) and sonographic biometry (bi-weekly). The opinions considering termination of pregnancy because of intertwin growth discordancy were divided; however, discordancy per se, was not considered an indication for cesarean delivery. An adapted management flowchart that summarizes the survey's data is presented and may be used as a standard for future investigations.

scholarly journals Drinking and mortality: long-term follow-up of drinking-discordant twin pairs

Addiction ◽  
2015 ◽  
Vol 111 (2) ◽  
pp. 245-254 ◽  
Author(s):  
Pyry Sipilä ◽  
Richard J. Rose ◽  
Jaakko Kaprio
Keyword(s):  
Long Term Follow Up ◽  
Discordant Twin

scholarly journals Renal Allograft Torsion: US and CT Imaging Findings of a Rare Posttransplant Complication

2016 ◽  
Vol 2016 ◽  
pp. 1-3 ◽  
Author(s):  
Rohit Dewan ◽  
Anil K. Dasyam ◽  
Henke Tan ◽  
Alessandro Furlan
Keyword(s):  
Doppler Ultrasound ◽  
Renal Allograft ◽  
Color Doppler ◽  
Color Doppler Ultrasound ◽  
Imaging Findings ◽  
Unenhanced Ct ◽  
Doppler Signals ◽  
History Of ◽  
Normal Blood Flow

Vascular torsion is a rare renal transplant complication which requires prompt diagnosis and surgery to salvage allograft function. We report here a case of renal allograft torsion with interesting imaging findings on unenhanced CT and color Doppler ultrasound. A 60-year-old woman with a history of pancreas and kidney transplant presented to the emergency room with nausea, vomiting, abdominal pain, and minimal urine output. Unenhanced CT of the abdomen demonstrated an enlarged and malrotated renal allograft with moderate hydronephrosis. Color Doppler ultrasound demonstrated lack of vascularity within the allograft. The patient was taken urgently to the operating room where the renal allograft was found twisted 360 degrees around the vascular pedicle. After the allograft was detorsed, the color of the kidney returned and the Doppler signals for arterial flow improved. Intraoperative biopsy showed no evidence of infarct or acute cellular rejection. The detorsed kidney was surgically fixed in position in its upper and lower poles. Follow-up ultrasound 1 day later demonstrated normal blood flow to the renal allograft and the serum level of creatinine returned to normal.

scholarly journals Venous leakage treatment revisited: pelvic venoablation using aethoxysclerol under air block technique and Valsalva maneuver

2015 ◽  
Vol 87 (1) ◽  
pp. 1 ◽  
Author(s):  
Ralf Herwig ◽  
Salvatore Sansalone
Keyword(s):  
Doppler Ultrasound ◽  
Valsalva Maneuver ◽  
Color Doppler ◽  
Pde5 Inhibitor ◽  
Penile Prosthesis ◽  
Cost Effective ◽  
Color Doppler Ultrasound ◽  
Pde5 Inhibitors ◽  
Venous Leakage

Objective: We evaluated the effectiveness of pelvic vein embolization with aethoxysclerol in aero-block technique for the treatment of impotence due to venous leakage in men using sildenafil for intercourse. The aim of the procedure was to reduce the use of sildenafil. Methods: A total of 96 patients with veno-occlusive dysfunction, severe enough for the need of PDE5 inhibitors for vaginal penetration, underwent pelvic venoablation with aethoxysclerol. The mean patient age was 53.5 years. Venous leaks were identified by Color Doppler Ultrasound after intracavernous alprostadil injection. Under local anesthesia a 20-gauge needle was inserted into the deep dorsal penile vein. The pelvic venogram was obtained through deep dorsal venography. Aethoxysclerol 3% as sclerosing agent was injected after air-block under Valsalva manoeuver. Success was defined as the ability to achieve vaginal insertion without the aid of any drugs, vasoactive injections, penile prosthesis, or vacuum device. Additionally, a pre- and post- therapy IIEF score and a digital overnight spontaneous erections protocol (OSEP) with the NEVA™-system was performed. Results: At 3 month follow-up 77 out of 96 patients (80.21%) reported to have erections sufficient for vaginal insertion without the use of any drug or additional device. Four (4.17%) patients did not report any improvement. Follow up with color Doppler ultrasound revealed a new or persistent venous leakage in 8 (8.33%) of the patients. No serious complications occurred. Conclusions: Our new pelvic venoablation technique using aethoxysclerol in air-block technique was effective, minimally invasive, and cost-effective. All patients were able to perform sexual intercourse without the previously used dosage of PDE5 inhibitor. This new method may help in patients with contra-indications against PDE5 inhibitors, in patients who cannot afford the frequent usage of expensive oral medication or those who do not fully respond to PDE5-inhibitors.

Exacerbated mini-puberty of infancy in an ex-extreme preterm girl

2020 ◽  
Vol 13 (9) ◽  
pp. e235492
Author(s):  
Mafalda Casinhas Santos ◽  
Sara Limão ◽  
Patrícia Ferreira
Keyword(s):  
Ovarian Cyst ◽  
Luteinising Hormone ◽  
Vaginal Bleeding ◽  
Expectant Management ◽  
Central Precocious Puberty ◽  
Spontaneous Resolution ◽  
Breast Development ◽  
Long Term Follow Up

Vaginal bleeding can occur shortly after delivery in 3%–5% of newborns as a consequence of placental hormone withdrawal . Although usually benign, its differential diagnosis includes central precocious puberty, tumours and other pathological conditions. A girl born at 26 weeks of gestation presented with five episodes of vaginal bleeding, each lasting less than a week, initiated at 4 months of age. Luteinising hormone and oestradiol levels were in the pubertal range. Later, she exhibited breast development, with no other pubertal signs. An ultrasonography test revealed an impregnated endometrium and a right ovarian cyst with 43 mm of diameter. A cranioencephalic MRI was unremarkable. Clinicians adopted expectant management and there was clinical, hormonal and radiological resolution in 3 months. The spontaneous resolution suggested mini-puberty of infancy. This is usually an asymptomatic condition, but to date, four cases of an exacerbated form in extremepremature infants have been reported. Long-term follow-up data are missing.A girl born at 26 weeks of gestation presented with five episodes of vaginal bleeding, each lasting less than a week, initiated at 4 months of age. Luteinising hormone and oestradiol levels were in the pubertal range. Later, she exhibited breast development, with no other pubertal signs. An ultrasonography test revealed an impregnated endometrium and a right ovarian cyst with 43 mm of diameter. A cranioencephalic MRI was unremarkable. Clinicians adopted expectant management and there was clinical, hormonal and radiological resolution in 3 months. The spontaneous resolution suggested mini-puberty of infancy. This is usually an asymptomatic condition, but to date, four cases of an exacerbated form in extremepremature infants have been reported. Long-term follow-up data are missing.

scholarly journals Pseudoaneurysm with arteriovenous fistula of the prostate after pelvic trauma: Ultrasound imaging

2016 ◽  
Vol 88 (4) ◽  
pp. 317 ◽  
Author(s):  
Andrea B. Galosi ◽  
Camilla Capretti ◽  
Luca Leone ◽  
Marco Tiroli ◽  
Daniele Cantoro ◽  
...  
Keyword(s):  
Arteriovenous Fistula ◽  
Color Doppler ◽  
Pelvic Trauma ◽  
Selective Embolization ◽  
Distal Branch ◽  
Anechoic Area ◽  
Post Traumatic ◽  
Anterior Prostate ◽  
Recurrent Hematuria

Pseudoaneurysm (PA) associated with an arteriovenous fistula (AVF) of the internal pudendal artery branches are very uncommon. We report a case of post-traumatic PA with AVF connected to Santorini plexus. Diagnosis was made with trans-rectal ultrasound (TRUS) after recurrent hematuria. TRUS reported a 1.7 × 1.4 × 1.5 cm anechoic area, on anterior prostate apex close to Santorini plexus. The use of color Doppler in this area revealed high flow velocity that was indicative for AVF. The feeding artery was a distal branch of the left pudenda artery. After selective embolization was observed complete occlusion of the feeding branches and disappearance of PA with AVF. Prostate PA with concomitant symptomatic AVF detected with TRUS has not yet described in literature after pelvic trauma and represents complex diagnostic challenges. This case report suggests that the use of TURS and color Doppler can provide an important diagnostic and follow-up to address the clinical suspicion of occult vascular injuries using a noninvasive approach.

scholarly journals Possibilities of Multiparametric Ultrasound Study with Contrast Enhanced in the Diagnostics of Cistic Kidney Lesions

2021 ◽  
Vol 4 (3) ◽  
pp. 35-43
Author(s):  
R. A. Kadyrleev ◽  
S. S. Bagnenkо ◽  
E. A. Busko ◽  
E. V. Kostromina ◽  
L. N. Shevkunov ◽  
...  
Keyword(s):  
Color Doppler ◽  
Renal Cysts ◽  
Color Doppler Imaging ◽  
Doppler Imaging ◽  
Cystic Kidney ◽  
Gray Scale ◽  
Ultrasound Study ◽  
Contrast Enhanced ◽  
Contrast Ultrasound

Purpose: To compare the capabilities and evaluate the effectiveness of gray-scale B-mode, Doppler mapping and contrast enhanced in the assessment of cystic renal lesions.Material and methods: Ultrasound examination (US) was performed in 61 patients with cystic kidney formations (category Bosniak ≥ II). Cysts of categories Bosniak ≥ III were histologically verified, rest (categories II–IIF) were under follow up. All patients underwent gray-scale ultrasound, color Doppler imaging and contrast enhanced (CEUS).Results: The efficiency of the B mode was: sensitivity 55.6 %; specificity 72.1 %; accuracy 62.3 %, in the CDI mode these indicators were 52.8; 80.1; 63.9 %, respectively. Contrast ultrasound significantly increased the capabilities of the method, and also made it possible to evaluate cystic formations according to the Bosniak criteria with indicators of the effectiveness of the method up to 100.0; 92.0; 96.7 %, respectively.Conclusions: CEUS demonstrated high informative value in the assessment of renal cystic formations in comparison with native ultrasound and Doppler modes, and therefore the technique should be considered as promising for inclusion in the algorithm of examination of complex renal cysts. 

scholarly journals Siamese twin pregnancy in peritoneal dialysis : first case in the world

2018 ◽  
Vol 1 (1) ◽  
pp. 39-42
Author(s):  
D El Hamssili ◽  
T. Bouattar ◽  
R. Bayahia ◽  
L. Benamar
Keyword(s):  
Peritoneal Dialysis ◽  
Twin Pregnancy ◽  
Antihypertensive Drugs ◽  
Successful Pregnancy ◽  
Dialysis Dose ◽  
Cerebral Malformation ◽  
Emergency Cesarean ◽  
First Case ◽  
Obstetrical Ultrasound

 Introduction: The probability of conception is low in peritoneal dialysis (PD), and the probability of successful pregnancy is even lower. Nearly 60 years after the first reported case of successful pregnancy in a dialysis patient, many questions about pregnancy during dialysis remain unresolved, namely the required dialysis dose, the follow-up rhythm, the choice of the the most appropriate dialysis technique. Case report: We report the first case worldwide of twin Siamese pregnancy in a patient on continuous ambulatory peritoneal dialysis (CAPD). The pregnancy was diagnosed at 7 weeks of amenorrhea (WA). The patient was initially under 2 exchanges per day, with 2-liter bags of Dianealof 1.36% glucose. As soon as the pregnancy was discovered, the prescription was modified, putting the patient under 3 exchanges a day with the same concentrates. The infusion volume was maintained at 2 liters up to 18 WA , and then reduced to 1.5 liters due to patient discomfort and abdominal hyperpressure. Daily ultrafiltration ranged from 180 to 800 ml with 1 liter diuresis. The blood pressure was well controlled, with an average of 125/80 mmHg, without need of  antihypertensive drugs. On a biological level, the Kt / V was 2.2, nPCR was 0.8, and the weekly clearance was 80 L / 1.73 m². The average hemoglobin was 11.5 g / dl under erythropoietin 9000 units per week. At 20 WA, obstetrical ultrasound revealed a mono-chorionic, mono-amniotic twin pregnancy. Due to high maternal and fetal risks, closer obstetrical control was indicated. At 24 WA, morphological obstetrical ultrasound coupled with Doppler examination of the uterine and umbilical arteries favored the diagnosis of mono-amniotic mono-chorionic twin pregnancy with strong suspicion of Siamese contiguous to the pelvis, with a cerebral malformation in one of the fetuses. The patient experienced intense contractions and pelvic pain leading to an emergency cesarean section with two surviving Siamese twins, contiguous to the pelvis, weighing 900g, but who died one day after delivery. Conclusion: Pregnancy during dialysis is at high maternal and fetal risks. It is necessary to prepare and follow this pregnancy to optimize the chances of success. This implies an adaptation of the medical treatment and dialysis prescription, including the volume and modality of exchanges. The same holds true for gynecological and obstetrical follow-up, which must be regular and strict, in order to prevent any maternal-fetal complications.

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