摘要:

The importance of teratology to obstetrician and patient has been demonstrated by the occurrence of a number of “mini-epidemics” of anomalies caused by drug ingestion during pregnancy. The scope of the problem is discussed, and drugs are reviewed by therapeutic classification for their teratologic potential.

ISSN:0029-7844    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

The efficacy and safety of bromocriptine mesylate (5 to 7.5 mg per day for up to 24 weeks) were studied in 22 clinical trials involving 226 patients who had amenorrhea/galactorrhea associated with hyperprolactinemia and no demonstrable pituitary tumor. Of the 187 patients evaluated for efficacy, 80% experienced reinitiation of menses (or pregnancy without first having menses); the average treatment time (excluding those who conceived) was 5.7 weeks. Galactorrhea was significantly (at least 75%) reduced in 76% of the 187 patients after an average treatment time of 6.4 weeks, and was completely suppressed in 58% after 12.7 weeks. Maximum reduction in serum prolactin levels occurred within the first 4 weeks of therapy, and the reduced levels were maintained during treatment; moreover, there was a strong correlation between prolactin reduction and clinical improvement. Adverse reactions were reported by 68% of the 226 patients evaluated for safety; in general, these reactions were mild and transient. Several patients experienced hypotension, but only 1 discontinued therapy because of it. Based on these findings, bromocriptine mesylate was judged safe and efficacious for this purpose.

ISSN:0029-7844    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

The roll-over test has been reported to predict pregnancy-induced hypertension. The arm used to record blood pressure has never been specified. Since the level of the arm with reference to the heart is of great importance in the interpretation of blood pressure, we recorded the roll-over response (blood pressure change from left lateral to supine position) first in the right and then in the left arm of 9 men and 8 nonpregnant women. In addition, blood pressure was measured simultaneously in both arms in 10 pregnant primigravidas. In the men and nonpregnant women the mean diastolic blood pressure after rolling over rose when the right arm was used and fell when the left arm was used. The difference in the roll-over response (right versus left arm) was accounted for by the hydrostatic effect produced by the vertical distance between the corresponding brachial arteries with the subject in the left lateral recumbent position. In the pregnant subjects as well, there was a difference between the roll-over response in the right versus left arm, accounted for by hydrostatic factors. However, the increase in blood pressure was greater for both arms, suggesting a real change in central blood pressure.

ISSN:0029-7844    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

The diagnosis, pathophysiology, and treatment of adult respiratory distress syndrome (ARDS) are discussed and 2 cases are presented. ARDS has varied etiology but common clinical, roentgenographic, and pathologic findings; it has been increasingly recognized as an important cause of morbidity and mortality in seriously ill patients. The obstetrician-gynecologist must be aware of this condition, for survival depends upon prompt diagnosis and meticulous therapy of the condition and its underlying cause.

ISSN:0029-7844    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

Three hundred sixty-two pregnant patients at risk for placental insufficiency were evaluated with the oxytocin challenge test (OCT) and urinary estriol determinations. The perinatal mortality in patients with positive tests was 6 times higher than the perinatal mortality in patients with negative tests. Expectant treatment of patients with a positive OCT was associated with a perinatal mortality 6 times higher than if immediate delivery was accomplished. A negative stress test was reassuring, as the risk of death in utero within a week of a negative test was only 0.3%. The combination of low estriol levels and positive OCT was quite ominous, while the presence of normal estriol levels provided reassurance of good perinatal outcome when expectant treatment of a patient with a positive OCT was undertaken. The overall perinatal mortality of the patients in this study was not different from that in the general obstetric population.

ISSN:0029-7844    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

Fetal heart rate (FHR) recordings of 138 deliveries with the fetus in the occiput posterior position (OPP) are compared with recordings of 138 control fetuses in the occiput anterior position (OAP). The 2 groups are comparable in maternal age, parity, duration of first stage of labor, frequency of nerve blocks for analgesia, and incidence of cord complications. Variable decelerations were significantly more frequent and more pronounced in the OPP group than in the controls. The number of newborns with low Apgar scores was similar in both groups, despite a large number of pronounced decelerations in the OPP group. Possible mechanisms for the origin of variable decelerations in the occiput posterior position are discussed.

ISSN:0029-7844    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

One thousand women underwent amniocentesis as part of a prenatal investigation and were observed throughout gestation and delivery. Amniocenteses and chromosome determinations were performed at a center with great experience in these techniques. Under these conditions, the risks attached to amniocentesis are minimal, and the chromosome determinations are reliable. In this study, 21 women chose to terminate their pregnancy because the fetus was expected to have a serious abnormality. In all the cases in which the diagnosis could be investigated after legal termination, the cytogenetic diagnosis proved correct.

ISSN:0029-7844    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

Ocular fundi of 410 newborns were examined for retinal hemorrhages within 24 hours after delivery. The purpose of this study was to investigate whether the course of pregnancy and management of delivery influence the incidence of neonatal retinal hemorrhage (RH) and whether this incidence could be reduced by electronic monitoring of delivery. To assess the prognostic value of neonatal RH for future development of the child, the physical, motor, and psychologic states of 252 infants were examined 6 to 18 months following delivery. The incidence of RH was 37.3% and was not influenced by maternal age, parity, gestational age, course of pregnancy, birth weight, or electronic monitoring of delivery. The mode of delivery did influence the incidence of RH. Gesell developmental schedule showed no correlation between ocular findings and later development of the child.

ISSN:0029-7844    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

A randomized controlled investigation was undertaken to evaluate the role of maternal oral antibiotic therapy in decreasing the incidence of maternal and neonatal colonization at term with group B β-hemolytic streptococcus (GB-BHS). Data were collected to determine the optimum transfer media and the colonization rate in the study population. At delivery 1441 maternal-infant pairs were evaluated. One hundred sixty-eight women (11.6%) and 55 infants (3.8%) were colonized. Forty-four women colonized with GB-BHS at 38 weeks' gestation were randomly assigned to a treatment (500 mg potassium penicillin or erythromycin ethylsuccinate q.i.d.) or a control group to determine the value of antepartum oral antibiotic therapy in preventing infant colonization. There was a significant reduction in maternal (P= 0.008) and infant (P= 0.004) colonization rates in the treatment group. There were no observed complications of antibiotic therapy in mothers or infants. This study suggests that routine cultures for GB-BHS should be done at 38 weeks' gestation. Mothers colonized at this time may be considered candidates for prophylactic antibiotic treatment.

ISSN:0029-7844    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

Five time-related peripartum events were prospectively studied in 101 high-risk, internally monitored parturients. These included the duration of labor, the duration of ruptured membranes, the number of vaginal examinations, the length of time from first vaginal examination to delivery, and the duration of internal monitoring. Seventy patients were delivered vaginally and 31 by cesarean section. Several of the time-related peripartum events were found to be individually related to postpartum morbidity. However, combined evaluation by stepwise discriminant analysis revealed that the duration of labor alone was the primary determinant of postpartum morbidity. These findings imply that the observation of a relationship between postpartum morbidity and any of several peripartum time-related factors in isolation may be mediated by its relationship in time to labor duration. This suggests, in turn, that intensive labor monitoring techniques in high-risk patients would not be expected to increase postpartum morbidity above that expected from increases in labor duration alone. The results further suggest that the duration of labor may be the only time-related peripartum event useful in evaluating the risk for postpartum infection in monitored patients in labor who undergo cesarean section.

ISSN:0029-7844    

出版商:OVID    

年代:1980

数据来源: OVID