摘要:

Eighty-nine maternal deaths occurred at Charity Hospital of New Orleans between 1965 and 1984, for an overall rate of 60.8 per 100,000 live births. The mortality rate increased with increasing maternal age, was greater with cesarean than vaginal delivery, and has not continued to decline over the 20-year interval. Of those decedents delivered abdominally, more than half of the deaths were attributable to operative complications, including anesthesia, rather than to an underlying disease. Although the majority of obstetric deaths were attributable to complications of hypertension, hemorrhage, and infection, the single most common cause at autopsy was pulmonary edema. Potentially preventable pulmonary edema was responsible for one-third of the obstetric deaths from hypertension and hemorrhage.

ISSN:0029-7844    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

Term fetal deaths occurring in Virginia in 1983 were reviewed to determine potential preventability. During this period, 52 (48%) of 108 such deaths were judged preventable. The leading cause of preventable antepartum death was maternal hypertension, followed by diabetes, inadequate fetal surveillance, and postterm pregnancy. The major cause of intrapartum fetal death was long delay between the onset of obvious fetal compromise and delivery. The incidence of preventable term stillbirth seemed inversely proportional to hospital size.

ISSN:0029-7844    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

In 12 patients requiring pulmonary artery catheterization, cardiac output was measured using Doppler and thermodilution techniques. The Doppler technique accurately predicted measurements made by thermodilution (r= 0.91;P< .001). Eighteen normal patients in the third trimester and 36 preeclamptics who had not been treated with medications other than magnesium sulfate were evaluated with Doppler alone. Of note was the heterogeneity among preeclamptics. Although their mean systemic vascular resistance was elevated, it ranged from 2256–648 dyne·sec·cm-5. Cardiac output ranged from 13.2–3.9 L/minute.

ISSN:0029-7844    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

Echocardiography is a simple, accurate, and noninvasive technique for the study of the pericardium. Twenty-one normal pregnant women in their third trimester were examined with the Smith-Kline Ekoline 20 Ultrasonoscope. Twelve (57.1%) had normal echocardiography, and nine (42.9%) had pericardial effusion: four mild, three moderate, and two large in amount. There was no correlation between the amount of pericardial effusion and the red blood cell and white blood cell counts, hemoglobin level, total serum protein, serum albumin level, or albumin/globulin ratio. One patient with moderate effusion was followed for 50 days after delivery, by which time the effusion had resolved completely.

ISSN:0029-7844    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

In this study, the cardiac circumference as measured in a four-chamber view was analyzed to determine its relationship to three linear, sonar measurments—biparietal diameter, femoral length, and abdominal circumference—and two sonographically derived fetal parameters— gestational age and estimated fetal weight. The results showed that the magnitude of the cardiac circumference as a function of any or all of these variables be used as an index of organ size when assessing fetuses at risk for anomalous cardiac development.

ISSN:0029-7844    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

Twenty-four patients with pure dysgerminoma of the ovary were treated at The University of Iowa Hospitals and Clinics between 1935 and 1985. Ten patients had stage I unilateral tumors, and all are free of disease from 20–455 months (median, 100 months). All patients treated by unilateral adnexectomy alone for stage IA disease survived. Nine of 11 patients with advanced disease whose therapy began or was completed at our institution are alive without disease from 12–204 months (median, 60 months). Three patients were referred with recurrent disease, and none survived.

ISSN:0029-7844    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

Review of the admissions to the Gynecologic Oncology Service at the University of Alabama Medical Center over a 12-year period reveals that 1% of all referrals had nongynecologic malignancies. Duration of symptoms was short; of 40 patients with adequate follow-up, 31 (77%) were dead from their cancer, with a median survival of eight months. The value of diagnostic radiologic procedures was assessed and, while these procedures proved helpful, most patients required a surgical procedure (often a reoperation) to establish the diagnosis.

ISSN:0029-7844    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

The DES Screening Center of Queens, Nassau, and Suffolk counties has screened approximately 2000 diethylstilbestrol (DES)-exposed women since its inception in 1979. Four women, who at their initial visit were noted to have only nonmalignant DES-related changes, subsequently developed clear-cell adenocarcinoma while under observation, between 18–81 months after their first colposcopy. The age at diagnosis ranged from 16–31. Three patients had been receiving close follow-up; one had not. These cases emphasize the need for frequent follow-up for these patients using careful inspection and palpation, vaginal and cervical cytology, colposcopy, and colposcopically directed biopsy of suspicious areas.

ISSN:0029-7844    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

The present study correlated the hysterographic and non-radiation-affected uterine histologic findings in 91 patients with suspected uterine cancer. Hysterography helped diagnose correctly a benign or malignant lesion, and helped identify the correct primary site of a malignant lesion in 11 patients. In 65 patients with a final diagnosis of endometrial carcinoma, all five cases of true endocervical involvement were identified, 69% were determined to have either no residual tumor or no myometrial invasion, and 88% were predicted correctly to have a myometrial invasion of greater than one-half. Prediction of the volume, distribution, and point of maximum invasion permitted the uterus to be opened so as to permit the best histologic assessment of the depth and extent of the lesion.

ISSN:0029-7844    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

One hundred thirty-five patients undergoing vaginal hysterectomy were randomly assigned to one of three regimens of prophylactic antibiotics. There was no statistically significant difference among the three groups in the incidence of postoperative pelvic cellulitis, fever index, or duration of hospitalization. A single preoperative dose of cefazolin was as effective as three perioperative doses of cefazolin or a single dose of cefonicid in preventing postoperative infectious morbidity.

ISSN:0029-7844    

出版商:OVID    

年代:1987

数据来源: OVID