Obstetrics and gynecology
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Four cases of combined vaginal-abdominal delivery of twins are presented, and an additional 5 cases from the recent literature are discussed. Malposition, malpresentation, and contracted cervix were the main indications for cesarean section for the birth of twin B. In the 9 cases presented, there were 2 perinatal deaths.
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Obstetrics and gynecology · Feb 1981
A simple and sensitive color test for the detection of human chorionic gonadotropin.
A simple, rapid, sensitive, and reliable ELISA test for the detection of urinary human chorionic gonadotropin (hCG) has been developed using penicillinase (EC no. 3.5.2.6) as the label and a microtiter ELISA plate as a solid support for antibody. The results of the test is assessed visually for the dark blue that indicates the presence of hCG. A minimum of 500 mU of hCG/ml of urine can be detected easily and the test can be completed in 2 hours with good precision. ⋯ In samples referred for pregnancy detection 95.5% accurate results were obtained when compared with histopathologic and/or clinical findings. There were 2 false-negative results, and only in 4 of 132 subjects studied were false-positive results obtained. This test, if properly performed, should prove a valuable tool in the detection of hCG as early as 30 to 35 days from the last menstrual period.
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Obstetrics and gynecology · Nov 1980
Effects of magnesium sulfate treatment on perinatal calcium metabolism. II. Neonatal responses.
To evaluate the effects of maternal magnesium sulfate treatment on neonatal magnesium and calcium homeostasis, the authors studied 23 term neonates whose mothers had received intravenous magnesium sulfate for pre-eclampsia and compared them with 14 control neonates. Total and ionized calcium, magnesium, phosphorus, and albumin were measured in maternal and umbilical blood; total calcium, magnesium, phosphorus, and albumin were measured serially in the newborn infants. Magnesium levels were higher in treated than in control infants in umbilical venous and arterial blood samples and in the neonatal blood samples 2, 12, and 24 hours after delivery. ⋯ Calcium levels were not significantly different in treated versus control subjects in umbilical blood or in any neonatal samples. There was no correlation between the maternal magnesium concentration at delivery and the levels of calcium in umbilical or neonatal blood. These data indicate that maternal magnesium sulfate therapy does not cause neonatal hypocalcemia and that the induced neonatal hypermagnesemia is resolved within the first 48 hours of life.
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Obstetrics and gynecology · Nov 1980
Comparative StudyFetal acid-base state following spinal or epidural anesthesia for cesarean section.
The authors compared fetal acid-base state and maternal blood pressure response in 111 women undergoing repeat cesarean section with either epidural or spinal anesthesia. Fetal umbilical acidemia (umbilical venous pH less than 7.25 or umbilical arterial pH less than 7.20) was more commonly observed following spinal anesthesia with a preanesthetic fluid load of 500 to 999 ml (20% of cases) than with epidural anesthesia (4% of cases. ⋯ The maximum reduction in systolic blood pressure following spinal anesthesia was not related to preanesthetic fluid load; however, in cases of severe hypotension the hypotensive episode was shorter and easier to treat when the preanesthetic fluid load was 1000 to 1500 ml rather than 500 to 999 ml. These data suggest that women receiving spinal anesthesia for repeat cesarean section should be given an intravenous fluid load of 1 liter or more.
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Obstetrics and gynecology · Oct 1980
Case ReportsHenoch-Schönlein (anaphylactoid) nephropathy in pregnancy.
A rare case of Henoch-Schönlein nephropathy in pregnancy is described. The course of the patient's stable nephrotic syndrome was unchanged in early and middle pregnancy. ⋯ The 1320-g infant survived without respiratory distress syndrome. The mother tolerated surgery well and within a week after surgery was approaching her prepregnancy renal status.