摘要:

The perinatal mortality associated with breech presentation at the Royal Women's Hospital, Melbourne, between 1974 and 1976 was 10.4%, or almost 5 times the overall hospital figure. Nine of 487 infants (1.8%) weighing ≥2500 g died in the perinatal period, but 7 were already dead at the onset of labor or had congenital abnormalities incompatible with life. Sixty of 177 infants (33.9%) weighing 1000-2499 g died in the perinatal period, but 28 of these died due to prematurity alone or from complications of intrauterinc hypoxia or birth trauma. Although elective cesarean section for breech presentation could not be justified for infants weighing ≥2500 g, this procedure may well reduce the perinatal loss of premature infants by reducing the incidence of intrauterine hypoxia and preventing birth trauma.

ISSN:0029-7844    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

Except during the last 2 gestational weeks, the brain is nearer its full-term size than the body is throughout prenatal development. This observation is consistent with the concept of a cephalocaudal axis of priority on the available nutritional supplies. The determination of ponderal maturity gradients shows the ascendancy of brain over somatic growth to be most marked in the first half of gestation. In absolute figures, both brain and somatic development are greatest toward the end of the intrautcrinc period when their respective weights are doubled in the last 9 and 11 weeks. Because the brain: somatic percentage index varies throughout intrauterinc development, it cannot be used as a means of determining asymmetric intrauterine growth retardation (ILJGR) in the fetus in the absence of accurate information on gestational age. When brain weight is expressed as a modified exponential function of somatic weight, the relationship is constant throughout fetal ontogeny and shows stronger covariability (p=0.9867) than the brain: body weight relationship. This method of expressing brain weight as a function of somatic weight is, therefore, useful as a means of appraising the quality of growth in cases at risk for asymmetric IUGR.

ISSN:0029-7844    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

In an ongoing prospective study at 2 hospitals, 114 cesarean section patients were studied to determine whether giving ampicillin after umbilical cord clamping is as effective as perioperative ampicillin in reducing maternal postoperative morbidity. The same patients have also been studied to determine the effect of prophylactic cesarean section ampicillin on the newborn. Results have shown that prophylactic ampicillin initiated after cord clamping is as effective in reducing maternal morbidity as ampicillin initiated prior to the surgery. There is also no evidence from our study that the transplacental passage of prophylactic ampicillin increases immediate or delayed neonatal infections.

ISSN:0029-7844    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

This study was designed to examine various risk factors in regard to their correlation with carbohydrate intolerance and in relation to birthweight and well-being of the newborn. Of the various alleged prediabetic stigmata among a selected group of 390 women, only marked maternal overweight, diabetes in previous pregnancy, family history of diabetes at the sibling level, and accompanying maternal morbidity were associated with increased risk for both gestational carbohydrate intolerance and for morbidity in the newborn. In women over 30 years of age a definite increase in the incidence of carbohydrate intolerance was noted among this high-risk population. Multiplicity of screening criteria presented a significantly (P> 0.001) greater risk for the development of carbohydrate intolerance and was seen to be positively correlated ( P>0.001) with increased perinatal morbidity.

ISSN:0029-7844    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

One hundred fifty patients undergoing cesarean section were evaluated prospectively for the effect of prophylactic antibiotics on postoperative morbidity. The postoperative infection rate was significantly reduced, being 30%, 16%, and 50% in the ampicillin, the cephalothin, and the control groups, respectively. The results are favorably compared with the results achieved in previously reported studies where the antibiotic treatment was started preoperatively. Our study confirms experimental studies that postoperative infection can be reduced by using prophylactic antibiotics in the immediate postoperative period. By this regimen, undesired placental transfer of the antibiotics to the fetus can be avoided.

ISSN:0029-7844    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

This study utilized internal fetal monitoring and an on-line voltage control oscillator for measurement of uterine activity unit (UAU) determination in patients who received a paracervical block (PCB) with the use of bupivacaine hydrochloride (Marcaine). The total dose of 25 mg (5 cc/side) of 0.25% bupivacaine used for PCB in 32 patients produced no ill effects to the fetus, as reflected by baseline fetal heart rate (FHR), beat-to-beat variablity, or Apgar scores. No adverse maternal effects were noted, and anesthesia was rated good or excellent in 81% of patients. Rate of cervical dilation remained the same or increased in 29 of 32 patients. Quantitative UAUs showed a significant decrease in the third 10-minuto interval after block in primiparas, but no significant change in multiparas or in the group taken as a whole. Total UAUs before versus after PCB for either group or taken together were not statistically different. A decreasing trend in UAUs after PCB versus a positive regression line from activity prior to the block was noted.

ISSN:0029-7844    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

In a comparative trial, cthanol effectively arrested preterm labor for 48 hours for more in 32% of cases, β-adrenergic agent (salbutamol) in 60% of cases (not statistically significant), and a combination of ethanol and indomethacin in 70% of cases (statistically significant, P<0.5). Labor was delayed for 14 days or more in 36, 60, and 50%, respectively (not statistically significant). The numbers studied were small, and tests of statistical significance were of doubtful value. Salbutamol was more acceptable to patients and the staff than ethanol. The trial was suspended and eventually abandoned due to reports of prostaglandin synthetase inhibitors causing premature closure of the ductus arteriosus. In this series no problems were encountered with the use of indomethacin.

ISSN:0029-7844    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

Herpes zoster has rarely been noted to occur during pregnancy. We report the case of a woman at 37 weeks' gestation who developed herpes zoster and 3 weeks later delivered a normal infant. A 6-month follow-up has revealed no sequelae in the child. Pertinent clinical aspects of herpes zoster and a review of the literature indicating a favorable prognosis for infants exposed in utero are presented.

ISSN:0029-7844    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

Twenty-three nonsmoking pregnant women ranging in age from 16 to 34 years and free of any signs or symptoms of pulmonary disease were evaluated by arterial blood gas values, while both sitting and supine, and closing volumes (CV) within 6 weeks of delivery and in the immediate postpartum period. Arterial oxygen tensions are usually normal while sitting, but modest hypoxemia occurs in about 25% of healthy young women while supine. The calculated alveolar- arterial gradient (A-a O2) was generally abnormal in the supine position, and in 11 of 23 women was greater than 20 mmHg. This abnormality persisted in the immediate postpartum period. Closing volumes fell significantly after delivery, but there was no significant relationship between changes in closing volumes and the arterial oxygen tension or the A-a O2. The presence of an elevated A-a O2is not helpful in the assessment of possible pulmonary embolism in this population. To avoid overdiagnosis of pulmonary embolism, more attention should be given to the actual value of the arterial Po2, which should be drawn while the patient is in the upright position.

ISSN:0029-7844    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

A questionnaire developed to assess changes in patterns of perinatal care related to regionalization programs was sent to all 505 members of The American College of Obstetricians and Gynecologists in the state of-Massachusetts. Respondents reported changes in facilities, services, educational experience, and referral and transfer patterns. The implications of these changes are discussed.

ISSN:0029-7844    

出版商:OVID    

年代:1979

数据来源: OVID