American journal of obstetrics and gynecology
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Am. J. Obstet. Gynecol. · Aug 1990
Case ReportsDiabetic ketoacidosis and insulin resistance with subcutaneous terbutaline infusion: a case report.
Diabetic ketoacidosis may occur in women treated with intravenous beta-sympathomimetic agents for tocolysis. We describe diabetic ketoacidosis and transient severe insulin resistance in a woman with diabetes who was treated with subcutaneous terbutaline infusion. Subcutaneous terbutaline infusion may precipitate transient insulin resistance and diabetic ketoacidosis in women with diabetes.
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Am. J. Obstet. Gynecol. · Aug 1990
Case ReportsRupture of unscarred uterus in primigravid woman in association with cocaine abuse.
Cocaine use in pregnancy has been associated with preterm labor and abruptio placentae. We report a case of rupture of an unscarred uterus necessitating hysterectomy in a patient after cocaine abuse.
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Am. J. Obstet. Gynecol. · Jul 1990
Case ReportsDiscrepancy in the diagnoses of hydatidiform mole by macroscopic and microscopic findings and the deoxyribonucleic acid fingerprint method.
Ten cases of hydatidiform mole were analyzed by the deoxyribonucleic acid fingerprint method. Deoxyribonucleic acid samples were prepared from hydatidiform mole tissue of hydatidiform mole and maternal and paternal blood. A case of partial hydatidiform mole diagnosed by histologic findings was revealed to be complete hydatidiform mole by deoxyribonucleic acid fingerprinting.
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Pregnant sheep are more vulnerable to the toxic effects of bupivacaine, a potent local anesthetic, than are nonpregnant sheep. In contrast, ovine pregnancy does not enhance the toxicity of mepivacaine, a drug with properties similar to lidocaine. We studied the central nervous and cardiovascular toxicity of lidocaine in pregnant sheep receiving a continuous intravenous drug infusion at the rate of 2 mg/kg/min and compared our results with data previously obtained in nonpregnant ewes. ⋯ At circulatory collapse, these concentrations were 35.1 +/- 3.2 and 41.2 +/- 6.7 micrograms/ml, respectively. It appears that pregnancy does not enhance the toxic effects of lidocaine. These findings are similar to those for mepivacaine but not for bupivacaine, and may be related in part to differences in the way pregnancy affects serum protein binding of these drugs.
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Am. J. Obstet. Gynecol. · May 1990
Scientific advances, societal trends, and the education and practice of obstetrician-gynecologists.
Specialization in medicine in the United States began in Colonial America and expanded rapidly, spurred by increasing scientific information and advancing technology. By 1972, when the American Board of Obstetrics and Gynecology instituted subspecialty divisions, it had become impossible for the general obstetrician-gynecologist to remain competent in all areas of our specialty. Changes we can anticipate are a decreasing need for operations and hospital care coupled with increasing emphasis on primary health care for women. Most of our resident education programs have not yet reflected the need to begin to prepare obstetrician-gynecologists for a role that will be quite different from their present one.