American journal of obstetrics and gynecology
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Am. J. Obstet. Gynecol. · Sep 1996
The feasibility of a randomized clinical perinatal trial: maternal magnesium sulfate for the prevention of cerebral palsy.
Because recent epidemiologic data suggest an association between maternal magnesium sulfate use and a decreased risk of cerebral palsy in infants who survive preterm birth, we investigated the feasibility of a randomized trial of intrapartum maternally administered magnesium sulfate to prevent cerebral palsy in children who were born before term. ⋯ A randomized trial of maternally administered intrapartum magnesium sulfate to reduce the rate of cerebral palsy in surviving preterm neonates would be a formidable undertaking, requiring a concerted multicentered effort.
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Am. J. Obstet. Gynecol. · Aug 1996
Hemodynamic effects of oral nifedipine in preeclamptic hypertensive emergencies.
Our purpose was to evaluate the hemodynamic effects of oral nifedipine in preeclamptic hypertensive emergencies. ⋯ Oral nifedipine appears to be an effective antihypertensive agent in preeclamptic hypertensive emergencies. A steady decrease in mean arterial pressure, systemic vascular resistance, and a mirrored increase in cardiac index are noted.
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Literature review was performed to analyze and define the current state of operative vaginal delivery. On the basis of published data, it is concluded that outlet and low forceps deliveries with < or = 45 degrees of rotation are effective and safe for both mother and baby. ⋯ It is likely that operative deliveries involving > 45 degrees of rotation will be abandoned in the future. It is further recommended that The American College of Obstetricians and Gynecologists 1988 forceps classification system be adopted for deliveries by vacuum extractors.
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Am. J. Obstet. Gynecol. · Aug 1996
Ethically justified guidelines for defining sexual boundaries between obstetrician-gynecologists and their patients.
This article proposes ethically justified guidelines that should govern the ethical obligations of obstetrician-gynecologists when they experience sexual feelings toward patients. ⋯ We propose a virtues-based ethical argument that is independent of informed consent for governing sexual relationships between obstetrician-gynecologists and their patients. In the context of the physician-patient relationship the professional virtues of self-effacement and self-sacrifice obligate the obstetrician-gynecologist to set aside and never act on feelings of sexual attractiveness toward patients.
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Am. J. Obstet. Gynecol. · Jul 1996
Fetal ionized magnesium levels parallel maternal levels during magnesium sulfate therapy for preeclampsia.
Little is known about ion regulation in fetuses. Our aim was to determine the effects of magnesium sulfate therapy on ionized (bioactive) magnesium in the cord blood of pregnancies complicated by preeclampsia. ⋯ In preeclamptic women undergoing magnesium sulfate therapy, ionized magnesium levels in cord blood parallel maternal levels. Before magnesium therapy ionized calcium levels were lower in preeclamptic women than in matched controls. In the presence of elevated magnesium levels ionized calcium appears to be tightly regulated.