Browsing by Author "Muller, L. M. M."

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    Adenocarcinoma of the stomach in pregnancy - Ultrasonographic diagnosis: A case report
    (Health & Medical Publishing Group, 1987-04) Muller, L. M. M.
    ENGLISH ABSTRACT: The ultrasonographic findings in a rare case of adenocarcinoma of the stomach in pregnancy are described. The patient presented with hyperemesis gravidarum in the second trimester.
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    Increased placental resistance and late decelerations associated with severe proteinuric hypertension predicts poor fetal outcome
    (Health & Medical Publishing Group, 1989) Pattinson, R. C.; Kriegler, E.; Odendaal, H. J.; Muller, L. M. M.; Kirsten, G.
    The flow velocity wave forms generated by Doppler ultrasound examination of the umbilical artery were correlated with feto-placental blood flow and numerically expressed as a ratio between the systolic (A) and the end-diastolic point (B). The technique is non-invasive and simple to perform. A cohort analytical study was done to see whether useful information could be obtained from the A/B ratio that could help in the management of patients with severe proteinuric hypertension. Fifty patients with severe proteinuric hypertension at less than 34 weeks' gestation were studied and serial Doppler ultrasound examinations of the umbilical artery were performed. No ultrasound results were made available to the clinician. An A/B ratio of 6 or greater was regarded as increased. Twenty-eight of the patients had an increased A/B ratio; in this group these 14 infants were small for gestational age, 14 developed late decelerations and there were 12 perinatal deaths. The remaining 22 patients had an A/B ratio of less than 6 and only 3 produced infants which were small for gestational age; 2 fetuses developed late decelerations and there was 1 perinatal death. A significant difference was found between the two groups in respect of these results. The group with an abnormal A/B ratio also experienced more neonatal morbidity. The A/B ratio of the umbilical artery wave form may assist in planning delivery of patients with severe proteinuric hypertension more accurately.
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    Ovulasie-induksie vir in vitro-bevrugting in Tygerberg-hospitaal
    (Health & Medical Publishing Group, 1987) Van der Merwe, J. P.; Kruger, T. F.; Lombard, C. J.; Muller, L. M. M.
    The protocol for in vitro fertilisation (IVF) at Tygerberg Hospital is presented and the results are analysed. Indications for ovulation induction for IVF included the following: (a) irreversible tubal damage; (b) infertility due to immunological factors; (c) male factor - infertility; and (d) endometriosis. A combination of human menopausal gonadotrophin (HMG) and clomiphene citrate (Clomid; Mer-National) and human chorionic gonadotrophin was used. Clomid is given in dosages of 100 mg for 5 days depending on the cycle length. Three doses of HMG (150 IU) are given on alternate days, starting on the second day of clomiphene treatment. If the leading follicle has not reached a mean diameter of 14 mm the day after the last HMG dose, another dose is given. This dosage is continued until the leading follicle reaches a diameter of 14 mm. A total of 109 cycles in 100 patients was analysed. Ova were considered to be mature as soon as the dominant follicle had reached a sonographic average diameter of 18 mm, another two follicles of 16 mm average diameter being present. Serum luteinising hormone levels were determined 4-hourly from the stage when the leading follicles exceeded an average diameter of 14 mm. In this study the pregnancy rate was 21.3% per laparoscopy and 24,4% per embryo transfer. The oestradiol levels on the 5th day of treatment have a predictive value of the length of stimulation.