Biomedical subjects

A R Dupre

Publications and source records attributed to A R Dupre.

3 recordsLinked to original sources

PubMed1993

Sexual assault.

Sexual assault continues to represent the most rapidly growing violent crime in America. Vital legal reforms are underway, but statistics prove a persistent rise in rape incidence with poor conviction rates. This knowledge, along with the vast multitude of emotional sequelae of rape and self-perceived inferior legal status of women, results in a high percentage of unreported cases. It is imperative that health care providers understand the horrific nature of sexual assault in order to provide appropriate care. All medical care personnel involved in the care of potential rape victims should be briefed in historic and modern legalities of sexual assault. Specific training in emergent and chronic care, both physical and mental, in conjunction with an understanding of rape legislation is vital if health care professionals are to appropriately care for victims of rape.

Child↗

PubMed1993

Clinical application of the Kleihauer-Betke test.

A prospective study was performed to investigate the benefit of serial quantitation of fetomaternal hemorrhage with the Kleihauer-Betke test for the prediction of neonatal/maternal outcome in pregnancies at risk for such bleeding. Of 65 patients, 14 (22%) had a positive Kleihauer test. Six of these women (43%) had evidence of placental abruption. Neonatal anemia (hematocrit < 48%) was present in only 2 of the 14 patients with a positive Kleihauer test (14%). Morbidity in the newborn correlated with gestational age at delivery, not with neonatal hematocrit. Maternal morbidity was not associated with a positive test. We conclude that Kleihauer-Betke testing is of limited value in patients at risk for fetomaternal hemorrhage.

Erythrocytes↗

PubMed1992

Trial of labor after cesarean delivery: experience in the non-university level II regional hospital setting.

OBJECTIVE: We sought to determine the extent to which vaginal birth after cesarean delivery was attempted since 1987 or 1988 in a representative sample of three regional level II hospitals in Mississippi. METHODS: The medical record department in each hospital identified all potential study subjects for this retrospective case series. One author abstracted relevant information from each medical record and entered it into a relational data base. RESULTS: Among 18,703 live births, 1574 patients had previous abdominal delivery (8.4%). Trial of labor was undertaken in 286 patients (18%), with an overall successful vaginal delivery rate of 71%. Although success rates for the three level II hospitals were similar (63-81%), utilization rates varied considerably (7-40%). One uterine dehiscence led to hysterectomy; otherwise, there were no serious perinatal complications or differences in measures of maternal morbidity, except for a higher incidence of endomyometritis with failed trial of labor (13 versus 3%). The only consistent differences observed between successful and unsuccessful trials in all groups were length of hospitalization and rate of cervical dilatation in active labor (1.4 versus 0.5 cm/hour). CONCLUSION: Although each regional level II hospital successfully conducted trials of labor in patients with previous cesarean birth, there was considerable variation among sites regarding frequency of utilization, suggesting a strong influence of nonclinical patient-physician factors upon the decision-making process.

Cesarean Section↗