ISSN:0038-4348    

出版商:OVID    

年代:1983

数据来源: OVID

ISSN:0038-4348    

出版商:OVID    

年代:1983

数据来源: OVID

ISSN:0038-4348    

出版商:OVID    

年代:1983

数据来源: OVID

ISSN:0038-4348    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

ABSTRACT: The one-minute Apgar score, proven useful for rapid assessment of the neonate, is often poorly correlated with other indicators of intrauterine well-being. Fetal asphyxia is directly associated with neonatal acidosis. A low Apgar score in the face of normal pH and base deficit does not, therefore, indicate an asphyxiated infant. We performed a study at Vanderbilt University Hospital to ascertain the feasibility of combining the pH value of umbilical arterial blood with the one-minute Apgar score for neonatal assessment. The pH values and Apgar scores were obtained on 172 singleton neonates. When the Apgar score was <7, over one half (56%) of the neonates had a normal pH value. Of this group 46% had undergone intubation and nasopharyngeal suctioning, procedures known to be associated with lowered Apgar scores. We recommend, therefore, that neonates with a one-minute Apgar score of <7 be further evaluated with umbilical arterial blood gas studies to ascertain the prsence of acidosis and to differentiate between metabolic and respiratory acidosis. More precise confirmation of the diagnosis of fetal distress and neonatal asphyxia, for both treatment and medicolegal purposes, is possible with this information.

ISSN:0038-4348    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

ABSTRACT: A study was performed to evaluate the effects of three regimens of intrapartum analgesia upon fetal heart rate characteristics. Either meperidine 50 mg (M50), meperidine 50 mg plus propiomazine 20 mg (M50/P20), or meperidine 25 mg plus propiomazine 10 mg (M25/P10) was given intravenously for intrapartum analgesia to 204 patients in the first stage of labor, and the effects were evaluated upon fetal heart rate variability (FHRV) and fetal heart rate reactivity (FHRR). M25/P10 was found to cause a decrease in FHRV in fewer patients than M50/P20 (13.6% vs 36.5%,P< .005), while still providing adequate analgesia for most patients. Although M50 also caused a decrease in FHRV in fewer patients than M50/P20 (19.1% vs 36.5%,P< .05), it produced emesis in 20% of patients. When FHRV was minimal or moderate before the analgesic was given, FHRV became absent in only eight of 222 doses (3.6%). FHRR was lost in fewer patients given M50 than in those given M50/P20 (45% vs 71%,P< .01); there was no significant difference between M50 and M25/P10. We conclude that the effects of meperidine upon fetal heart rate characteristics are both potentiated by propiomazine, and, when meperidine is given with propiomazine, dose-related. We also conclude that absent FHRV is rarely caused by meperidine; when FHRV becomes absent after meperidine administration, the patient should be fully evaluated for the possibility of fetal distress before the absence of variability is attributed to analgesia.

ISSN:0038-4348    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

ABSTRACT: In 42 diabetic patients evaluated by ultrasonography in the third trimester of pregnancy, 12 fetuses were found to have the diabetic halo. Of that group, the estimated fetal weight exceeded the 90th percentile in eight of nine studies in which the weight could be estimated sonographically. Overgrowth of the fetal head was not a finding in this group of patients and was not associated with the diabetic halo. The diabetic halo appears to be more accurate than the biparietal diameter as an indicator of infants that are large for gestational age.

ISSN:0038-4348    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

ABSTRACT: Eclampsia occurring more than 48 hours postpartum has been observed in an unusual number of patients. From August 1977 to November 1982 at E. H. Crump Women's Hospital and Perinatal Center (Memphis), there were 132 documented cases of eclampsia, of which 36 (27%) occurred postpartum. Seventeen (47%) of these occurred more than 48 hours postpartum. Preeclampsia was diagnosed before the onset of convulsions in 12 patients, all of whom received intravenous magnesium sulfate postpartum. The mean duration of postdelivery magnesium sulfate therapy was 32 hours (range 24 to 72 hours). Headaches and visual disturbances were reported by all 17 patients before onset of convulsions. Physical and laboratory findings immediately after the convulsions were consistent with eclampsia. Treatment consisted primarily of intravenous magnesium sulfate. Neurologic consultation was obtained to rule out a neurologic disorder, and metabolic studies were also done. Electroencephalograms were done on 15 patients; eight of them showed patterns consistent with encephalopathy.

ISSN:0038-4348    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

ABSTRACT: We evaluated a perinatal outreach education program to determine its “transportability” (usefulness to other regional centers). Three kinds of data were available from seven regional centers: (1) participation in the program by health care providers, (2) changes in cognitive knowledge, and (3) changes in neonatal care practices. Data were obtained from 2,735 program participants and from retrospective chart review of 2,781 at-risk babies born in participating hospitals. Analysis showed that results were comparable when the program was used by six regional centers from two states and when it was used by the regional center that originally developed the program. We therefore concluded that the Perinatal Continuing Education Program is transportable.

ISSN:0038-4348    

出版商:OVID    

年代:1983

数据来源: OVID

ISSN:0038-4348    

出版商:OVID    

年代:1983

数据来源: OVID