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Biomedical subjects

A H Schipul

Publications and source records attributed to A H Schipul.

7 recordsLinked to original sources
PubMed1998

Effectiveness of prostaglandin E2 intracervical gel (Prepidil), with immediate oxytocin, versus vaginal insert (Cervidil) for induction of labor.

OBJECTIVE: Our purpose was to compare the effectiveness of labor induction with use of prostaglandin E2 either as an intracervical gel (Prepidil), with immediate oxytocin, or as a sustained-release vaginal insert (Cervidil) with subsequent oxytocin as needed. STUDY DESIGN: Hospitalized patients at >/=37 weeks' gestation requiring labor induction and having an unfavorable cervix (Bishop score </=6) were randomly assigned to receive either Prepidil or Cervidil. Oxytocin was begun immediately after Prepidil placement or 30 minutes after removal of the Cervidil insert if needed. RESULTS: Of the 150 patients, there were no differences in demographics and eventual pregnancy outcomes between the Prepidil group (n = 77) and the Cervidil group (n = 73). Those pregnancies receiving the Prepidil-immediate oxytocin regimen were delivered sooner than those receiving the Cervidil among nulliparous (11.3 +/- 7.3 hours vs 25.2 +/- 12.5 hours, P <.001) and multiparous (8.4 +/- 7.8 hours vs 18.4 +/- 7.2 hours, P <.001) women. The mean cost savings, which favored the Prepidil-immediate oxytocin regimen, was $458 (range $204 to $630) per patient. CONCLUSION: Compared with Cervidil, the Prepidil-immediate oxytocin regimen resulted in a shorter induction-to-vaginal delivery interval and in more hospital cost savings without increasing adverse outcomes.

Administration, Intravaginal↗
PubMed1996

Successful urgent cerclage in a quadruplet gestation.

Pregnancies complicated by quadruplets are rare but at high risk for premature cervical dilation, premature deliveries, and increased perinatal mortality. This report presents a case of a patient carrying quadruplets whose cervix became 4 cm dilated at 21 weeks even though there were no reported uterine contractions. Despite bed rest and combination tocolytic therapy, the cervix dilated to 6 cm and the membranes protruded. Described here are refinements of an Olatunbosun technique to successfully perform the cerclage. Labor occurred at 32 weeks, and a cesarean delivery was performed before the transvaginal removal of the cerclage. The four appropriately-grown fetuses adjusted well in the intensive care nursery.

Adult↗
PubMed1995

Conjoined twins.

Conjoined twins, otherwise known as Siamese twins, have fascinated physicians and laymen alike for centuries. The minimal diagnostic criteria for conjoined twins is the fusion of some portion of mononuclear or monozygotic twins.

Abortion, Therapeutic↗
PubMed1988

Disability from endometriosis in the United States Army.

The impact of endometriosis on the general population has been well documented, and the prevalence rate is quoted as 10%. The records of 6,456 women in the United States Army were reviewed with respect to age, race and active duty status. The active duty records were further evaluated for total sick days from endometriosis-related problems. This evaluation revealed a mean sick time of 15 days per admission per active-duty patient regardless of age or race. The estimate of lost duty time was 21,746 days, considering all active-duty patients in the study (five years of records). The prevalence of endometriosis in the female U.S. Army population was 6.2%. Diagnosis and treatment of endometriosis should be aggressively pursued whenever the disease is suspected.

Adolescent↗
PubMed1986

Computed tomographic pelvimetry in the evaluation of breech presentation.

The purpose of this investigation was to assess computed tomographic (CT) pelvimetry in the evaluation of breech presentation for trial of labor. Thirty-two patients with singleton term breech deliveries formed the study group. Seventeen of the 32 (53.1%) patients fulfilled the criteria for attempted vaginal delivery. Fourteen of the 17 (82.4%) delivered vaginally. All infants so delivered had five-minute Apgar scores greater than or equal to 7. Three of the 17 patients required abdominal delivery: one for fetal distress and two for arrest of dilation. These results compare favorably with studies using conventional x-ray pelvimetry. The advantages of CT over conventional pelvimetry include ease of performance, ease of interpretation, and decreased radiation dose to the fetus.

Breech Presentation↗