摘要:

A 27 year old nulliparous woman presented to the hospital in January 1983, at 22 weeks' gestation with five days of headache, progressing to vomiting and disorientation. Physical examination confirmed the pregnancy, with no other significant findings. A mildly abnormal lumbar puncture was noted. Four hours after presentation the patient had a generalized seizure, followed by respiratory arrest. Resuscitation was successful in restoring normal vital signs, but the patient's neurologic status was consistent with the diagnosis of brain death. No brainstem reflexes were present, and the EEG was isoelectric on two occasions two days apart. CT scan of the head showed a mass obstructing the fourth ventricle, with marked dilation of the lateral and third ventricles. The neurologic status was unchanged despite steroids, mannitol, and aggressive management of intracranial pressure. The fetal heart rate pattern was normal throughout. Because of the father's strongly expressed wishes, full cardiorespiratory support was to be provided until the fetus reached viability.

ISSN:0275-665X    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Duke hospital is a tertiary care center with 24 h inhouse anesthesia, obstetric, and pediatric staffs and a neonatal intensive care unit. In 1982, a fetal diagnostic unit was established and vaginal delivery after previous cesarean section was offered to parents. No administrative directives regarding cesarean section were made during the study, but all physicians knew the rate was increasing. Information was gathered from records of women who delivered after 20 weeks of gestation. Six major diagnostic categories for primary cesarean deliveries were defined. Risk factors preceding delivery by cesarean section were compared with those preceding vaginal delivery. Rate of primary cesarean delivery, odds ratio, prevalence of each risk, attributable risk (the difference in the rates of primary cesarean delivery between exposed and unexposed groups), population-attributable risk (the risk of primary cesarean delivery in the entire population minus the risk in the unexposed group), and the population-attributable risk fraction (the fraction of risk in the population that represents the excess risk associated with exposure to the risk factor) were derived statistically. Logistic regression was used to assess changes in the odds ratios of risk factors by the year for those factors with odds ratios > 1.5, or a prevalence and a population-attributable fraction > 5%.

ISSN:0275-665X    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

The Maternal Mortality Collaborative, a Special Interest Group of ACOG, established voluntary surveillance of maternal deaths in 1983 to improve detection of maternal deaths, collect and analyze information, and make the results available for physician education. Collaborators from 19 areas submitted data on a standard worksheet that included death certificate data. From a review of each work sheet, a cause of death was assigned (ICD-9) and deaths were classed as maternal or nonmaternal. Subject ages were grouped by 5 year intervals, races as white, black or others, and maternal mortality ratios were calculated (deaths per 100,000 live births).

ISSN:0275-665X    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Pregnancy-induced hypertension (PIH) may involve multiple organ systems, with liver dysfunction a common manifestation. The current study was designed to assess the prevalence of elevated SGOT and its significance in PIH.

ISSN:0275-665X    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Recent data have indicated that CNS injury in the neonate may have significant intrapartum antecedents, possibly being more important than intrapartum or postpartum events. The current study was an effort to assess this concept on the basis of neuropathologic examination of brains from infants dying at age 7 days or less. Tissue examination was designed to identify and describe lesions, but also to determine their age on the basis of the stage of injury/repair noted.

ISSN:0275-665X    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Apgar scores have been considered indicative of birth asphyxia when 6 or below. However, such scores need not necessarily indicate the presence of hypoxia, acidosis (metabolic or respiratory) and low umbilical artery pH. The current study was designed to assess the degree of correlation between low Apgar scores and umbilical artery acid-base levels in low birthweight neonates.

ISSN:0275-665X    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Perinatal asphyxia remains a major cause of acute encephalopathy in the full-term neonate with resulting permanent neurologic handicaps. Although the effects of the initial hypoxic-ischemic insult may not be irreversible, cerebral edema may elevate ICP and reduce cerebral perfusion pressure (CPP), possibly producing secondary neurologic injuries or extending the effects of the original insult. The current study was designed to observe any correlation between ICP and EEG changes after perinatal asphyxia.

ISSN:0275-665X    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Endogenous opioids have been claimed to be responsible for pain threshold elevation in late pregnancy, by increased biosynthesis and/or reduced enzymatic degradation of opioid peptides in the CNS.CSF was obtained from 12 healthy women scheduled for elective cesarean section for CPD before anesthesia and from 8 healthy nonpregnant volunteers. Assays were performed of dynorphin-converting activity as well as levels of [Leu]enkephalin-Arg6, a derivative of prodynorphin-derived peptides.

ISSN:0275-665X    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Myocardial depression may occur with excessive doses of all local anesthetic agents, but certain drugs, such as bupivacaine, may also produce ventricular arrhythmias associated with cardiovascular collapse. The current study was designed to assess the electrophysiologic effects of both bupivacaine and lidocaine on ventricular muscle and Purkinje fibers.Right ventricular septal walls, including the right bundle branch and papillary muscle, were dissected out from fresh cardiac specimens of rabbits and suspended in a nutrient bath. Recording glass microelectrodes were inserted into Purkinje fiber cells and ventricular muscle cells for eventual display of action potentials. The preparation was paced at an amplitude twice threshold. Parameters determined included maximum diastolic potential (MDP), action potential amplitude (AP), maximum rate of depolarization &OV0312;max) and action potential duration (APD). Other data derived included effective refractory period (ERP), membrane responsiveness, and Purkinje fiber-ventricular muscle conduction (PF-VM).

ISSN:0275-665X    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

The authors describe 5 cases in which Doppler echocardiography was used for assessing aortic stenosis and pulmonary artery catheterization for guiding hemodynamic care. Regional anesthesia was employed without complications.

ISSN:0275-665X    

出版商:OVID    

年代:1989

数据来源: OVID