摘要:

&NA;Terbutaline was administered to 50 women, all diagnosed as being in labor prior to 36 weeks' gestation. In 47, uterine activity was initially arrested with intravenous therapy. The infusion rate required to arrest uterine activity ranged from 10 to 80 μg/min and 21 of the 50 patients (42%) required more than one intravenous infusion. The average prolongation of gestation was 3.7 weeks in those successfully treated. Twenty‐four delivered within 48 hours after the terbutaline was discontinued. Treatment failures occurred in 11 (22%). Not a single infant died of the respiratory distress syndrome. Side effects were mild and well tolerated.

ISSN:0029-7844    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

&NA;A correlation between high insulin levels in amniotic fluid and the appearance of diabetogenic fetal morbidity was found in radioimmunoassays of 487 samples of the fluid. The mean insulin level in metabolically normal pregnancies rose from 9 μU/ml (Week 27) to 15 μU/ml(Week 40). The insulin level in amniotic fluid of diabetic patients was elevated up to 27 times the mean. Insulin levels in the umbilical cord and urine of newborns of diabetic mothers were also elevated, to 29 and 21 times the mean, respectively. Elevation of insulin levels in amniotic fluid portends diabetogenic fetal morbidity. High and rising insulin levels at an early stage (26‐28 weeks) may indicate a high risk of preterm onset of labor. Regular adjustment of metabolic compensation on the basis of amniotic fluid insulin made it possible to reduce the level in 12 of 17 pregnant diabetic women by increasing insulin dosage. The 12 women were thereby enabled to carry their pregnancies to term and to await the onset of spontaneous labor without diabetogenic fetal morbidity. Beta‐stimulating agents affect glucose management and may cause elevated insulin levels in amniotic fluid.

ISSN:0029-7844    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

&NA;A study was carried out on the patient population of two cerebral palsy facilities serving Northeast New York State to evaluate obstetric factors which might be associated with the development of cerebral palsy. A combination of available medical records and a maternal questionnaire was used for analysis. Of 605 contacted, 158 mothers (26%) provided valid and detailed data, and the study was confined to these 158 patients. A positive association was found with increased reproductive loss, prematurity, and vaginal breech delivery. The need to develop and adopt a comprehensive uniform record system for the pregnant patient and her child is underscored. The limitations of a single factor retrospective study are acknowledged.

ISSN:0029-7844    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

&NA;Prophylactic cefazolin was evaluated in high‐risk obstetric patients who had invasive fetal monitoring and subsequent cesarean section. A three‐dose regimen of either cefazolin or placebo was administered randomly in a double‐blind manner to 93 patients, 48 receiving cefazolin and 45 placebo, with the first dose given when the cord was clamped. In the placebo group, 51% of the patients were treated for endomyometritis compared to 29% in the cefazolin group. The incidence of urinary tract and wound infections was similar in the 2 groups. One patient in the active drug group was diagnosed as having septic pelvic thrombophlebitis and received multiple antibiotics and heparin before she recovered. One patient in the placebo group required triple antibiotic therapy. Operation to control infection was not required in any patients and there were no maternal deaths. The cefazolin patients had fewer degree‐hours of morbidity as calculated by the quantitative fever index (P< 0.002). The perioperative use of cefazolin was efficacious in reducing the incidence of endomyometritis, but did not prevent serious postoperative pelvic infection.

ISSN:0029-7844    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

&NA;Group B beta hemolytic streptococcus (GBBHS) is a potential pathogen for the urinary tract during pregnancy. At this medical center, 19 of 371 patients with urinary tract infection (5.1%) presented with Group B beta hemolytic streptococcus as the proven causative microorganism. This microorganism should not be considered only as a contaminant when isolated by urine culture.

ISSN:0029-7844    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

&NA;From a clinical service using the contraction stress test as an evaluator of fetal well‐being, a 37‐month review of the significance of the suspicious contraction stress test was performed. There were no antepartum losses in a group of 107 patients whose initial test was suspicious. Following each testing a number of patients delivered spontaneously or were delivered for other reasons. Results in 5 of 67 patients at the second testing changed from a suspicious to a positive test, 36 became negative, and 26 remained suspicious. There were no further conversions to a positive test after the second testing. There is a strong correlation between the loss of fetal heart reactivity and the repeated suspicious contraction stress test. The chief value of the suspicious test is as a marker in the high‐risk pregnancy appraisal for consideration of additional fetal and maternal evaluation and possible clinical management alteration.

ISSN:0029-7844    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

&NA;Antepartum fetal evaluation by heart rate monitoring was carried out on a clinical service during a 1‐year period utilizing the nonstress test as the primary screening device. Nonreactive nonstress tests were supplemented by the oxytocin contraction stress test. In this study, the use of the nonstress test appropriately led to the identification of all fetuses who were in jeopardy and, in the majority of instances, identified fetuses in good condition who did not require the administration of oxytocin to determine fetal well‐being. In our experience, the nonstress test is a reliable, inexpensive, convenient, time‐saving screening procedure which can be made available to a greater number of patients than the contraction stress test alone.

ISSN:0029-7844    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

&NA;A new method of rapid antenatal assessment of fetal lung maturity was evaluated in relation to the newborn outcome and two other accepted tests. This method is based on fluorescence depolarization (FD) technique. The special instrumentation required for this method (the Microviscosimeter) was found to be simple and easy to handle even to nonprofessional personnel. Analysis of 47 samples of amniotic fluid received within 48 hours of delivery demonstrated that lung maturity threshold may be related to a numeric value (pvalue) measured by this technique. With aPvalue of less than 0.320 respiratory distress syndrome (RDS) is unlikely to develop. With aPvalue greater than 0.340, chances for RDS, usually severe, are high. With aPvalue of less than 0.340 but greater than 0.320, RDS may or may not develop. This method did not prove to be more reliable then the determination of L/S ratio by thin layer chromatography, but its advantage is that it supplies the results in less then an hour. The FD technique proved to be more reliable then the commonly used foam stability test.

ISSN:0029-7844    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

&NA;Intraluminal gastroesophageal pressure and pH studies have been performed on 8 nonpregnant women, 10 pregnant women with heartburn, and 10 pregnant women without heartburn. Each patient was tested under resting conditions and after intravenous injection of 0.6 mg atropine. In both groups of pregnant patients the intragastric pressure was found to be higher than that of the nonpregnant subjects. The stomach to lower esophageal sphincter pressure (LESP) gradient under resting conditions was least in the pregnant patients with heartburn. After the administration of atropine, a fall in the LESP occurred in all 3 groups of patients which was most profound in the nonpregnant subjects and in the pregnant patients without heartburn. These changes and the pH recordings of the lower esophagus indicate the adverse effect that atropine has on the competency of the LESP both in pregnancy and in the nonpregnant state. Atropine should therefore be used with caution as a premedicant and preferably combined with metoclopramide (Maxolon).

ISSN:0029-7844    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

&NA;A comparison of the endogenous creatinine clearance (ECC) values by using creatinine levels measured by the autoanalyzer and the modified Jaffe reaction using Lloyd's reagent was performed in 108 normal ambulatory pregnant women at various stages of gestation. The mean ECC was found to be significantly lower when the former method was employed except between 39 and 41 weeks when the values became similar. The mean ECC when calculated from the autoanalyzer results did not vary during pregnancy since serum creatinine by this method remained fairly constant. The difference in serum creatinine level between the two methods observed during pregnancy was absent in the nonpregnant state.

ISSN:0029-7844    

出版商:OVID    

年代:1978

数据来源: OVID