Showing papers by "Michael Hughes published in 1989"

Chromosomal abnormalities in fetuses with omphalocele. Significance of omphalocele contents.

Abstract: Twenty-six consecutive fetuses with a sonographically detectable omphalocele and known karyotype were reviewed to identify risk factors that might be associated with chromosomal abnormalities. Risk factors that were analyzed included contents of the omphalocele sac, maternal age, fetal sex, sonographically detectable concurrent anomalies, and any major concurrent anomaly. Chromosomal abnormalities were found in 10 cases (38%) from trisomy 18 (n = 4), trisomy 13 (n = 4), trisomy 21 (n = 1), or 45, X (n = 1). The absence of liver from the omphalocele sac (intracorporeal liver) was strongly associated with an abnormal karyotype; chromosomal abnormalities were present in all 8 fetuses with an intracorporeal liver compared to 2 of 18 fetuses with an extracorporeal liver (p less than .0001, two-tailed Fisher exact test). Other risk factors that were statistically associated with chromosomal abnormalities included advanced maternal age (greater than or equal to 33 years, p = .03) and sonographically detectable concurrent malformations (p = .05). We conclude that sonographic findings can help determine the relative risk of chromosomal abnormalities in fetuses with omphalocele; abnormal karyotypes were significantly associated with the absence of liver from the omphalocele sac and sonographically detectable concurrent malformations in this series. Sonographers should also be aware that omphaloceles that contain bowel alone tend to be small and can be missed or mistaken for other abdominal wall defects (gastroschisis or umbilical hernia).

Fetal omphalocele: prenatal US detection of concurrent anomalies and other predictors of outcome.

Abstract: Forty-six consecutive fetuses with an identified omphalocele were examined with prenatal ultrasound (US) to determine the accuracy of detecting concurrent malformations and to evaluate other possible indicators of fetal outcome. In 43 fetuses with adequate follow-up, 29 (67%) had additional malformations, including 23 with major malformations and six with minor malformations. Thirty-six fetuses (78%) died at termination of pregnancy (n = 23) or spontaneously (n = 13). With the exclusion of pregnancy terminations, fetal mortality was strongly associated with the presence of concurrent malformations, (P less than .001). In 10 surviving fetuses, only three had concurrent malformations, and all were minor. Fetal mortality was also found to be statistically associated with anomalies detected at US (P = .01) and abnormal amniotic fluid volume but was not associated with fetal ascites (P = .64) or omphalocele size (P = .65). Chromosome abnormalities correlated with the absence of liver in the omphalocele sac (P less than .001) and with abnormal amniotic fluid volume (P = .02). Prenatal US can help predict the outcome in fetuses with an omphalocele.

Parenthood and Psychological Well-Being Among the Formerly Married Are Children the Primary Source of Psychological Distress?

Abstract: Previous studies have found that children have a negative, albeit fairly weak, impact on the psychological well-being of parents. These studies have generally focused on married respondents and, to a somewhat lesser extent, unmarried women, but have generally ignored unmarried men. For the most part, studies of parenthood and well-being have not considered the issue of adult and/or absent children. Defining parenthood so it includes relations with adult children, absent children, and dependent children in the home, the present study compares the impact of parenthood on the well-being of formerly married men and women to that of married men and women. The findings confirm that nonparents experience better mental health than parents and further indicate that (1) variation in the parental role is more strongly associated with psychological well-being for men than for women, (2) parenthood is most strongly related to well-being among formerly married men, for whom the greatest problems occur with the presence...