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Biomedical subjects

B Chayen

Publications and source records attributed to B Chayen.

At least 19 recordsLinked to original sources
PubMed1995

Great grand multiparity--beyond the 10th delivery.

OBJECTIVE: To investigate the perinatal outcome and obstetric complications of women delivering for the 10th time or more. METHODS: Four hundred twenty women of great grand multiparity were analyzed in a modern health care setting and compared with our general population of obstetric patients, with regard to past history, maternal age, gestational age, mode of delivery, fetal outcome and intercurrent medical/obstetric problems. RESULTS: The study group showed significantly lower rates of low birth weight infants and instrumental delivery. No significant difference was seen in the incidence of cesarean section, pathologic fetal presentation, maternal hypertension, gestational diabetes, hemorrhage, or perinatal morbidity or mortality. There was a slightly higher incidence of twin births compared with the general population. CONCLUSION: It is probable that women capable of reaching their 10th delivery are basically healthy. If offered adequate perinatal care, they are not a high-risk group during subsequent deliveries.

Adult↗
PubMed1994

Successful pregnancy in a woman with cyanotic congenital heart disease after a palliative pulmonary-systemic shunt. A case report.

A 20-year-old woman with cyanotic congenital heart disease composed of corrected transposition of the great vessels, severe pulmonic stenosis, atresia of the left pulmonary artery and a large ventricular septal defect, had a successful pregnancy following a pulmonary-systemic shunt (Blalock-Taussig). The hemoglobin decreased from 21 to 16 g/dL following the operation. The antepartum course was complicated by intrauterine growth retardation and pregnancy-induced hypertension. A normal fetal nonstress test and biophysical profile permitted continuation of the pregnancy until 38 weeks' gestation, with delivery of a healthy infant.

Abnormalities, Multiple↗
PubMed1991

Neonatal alloimmune thrombocytopenia in consecutive pregnancies.

Neonatal and antenatal alloimmune thrombocytopenia is caused by the placental passage of maternal antibodies directed against platelet-specific fetal antigens. This disease is analogous to Rhesus hemolytic disease of the newborn and may be complicated by intracranial hemorrhage. Following increased awareness to the disease, it is currently no longer considered to be rare. Recent advances in the utilization of percutaneous umbilical cord blood sampling has led to a dramatic change in both prenatal and intranatal management of affected fetuses. We present a sibship with four infants, three of them found to have alloimmune thrombocytopenia. The neonatal thrombocytopenia in the subsequent births was not shown to be more severe, as could have been expected from the pathophysiologically analogous Rh hemolytic disease of the newborn. The role of prenatal determination of platelet count, intrauterine treatment with immunoglobulins and platelet transfusions, and elective cesarean section, in preventing possible hemorrhagic complications in repeated pregnancies should be reconsidered, taking into account the natural history of this rare disorder.

Blood Platelets↗
PubMed1989

Absence of end-diastolic umbilical artery blood flow predicts poor fetal outcome despite normal blood gases.

A case is reported in which the fetal acid-base status was assessed by means of cordocentesis in a fetus without end-diastolic umbilical artery blood flow. The absence of end-diastolic flow was not associated with acidosis or hypoxia. However, the fetal condition deteriorated 3 days later, which suggests that even with a normal fetal acid-base status, an extended margin of safety cannot be assumed with the absence of end-diastolic umbilical flow.

Acid-Base Equilibrium↗
PubMed1989

Intravascular exchange and bolus transfusion in the severely isoimmunized fetus.

Eight Rh-sensitized fetuses, between 21 weeks 2 days and 35 weeks of gestation, received 31 intravascular transfusions (13 exchange and 18 bolus) and one intraperitoneal transfusion under ultrasonographic guidance. The interval between transfusions was 13.4 +/- 4.7 days. Posttransfusion hematocrit dropped at a rate of 1.0% +/- 0.6% per day. Procedure time for the bolus transfusion was shorter than for the exchange transfusion (t test, p less than 0.001). Bleeding from the puncture site complicated 10 of the 31 intravascular transfusions, without apparent maternal or fetal consequences. Fetuses were delivered between 33 and 36 weeks of gestation, after lung maturity was achieved.

Adult↗
PubMed1989

Isoproterenol is an effective marker of intravenous injection in laboring women.

The purpose of this randomized, double-blind study was to determine if isoproterenol 5 micrograms iv produces a consistent, noticeable tachycardia in healthy, laboring women. Maternal heart rate, fetal heart rate, and uterine contractions were continuously recorded and maternal blood pressure was measured every minute for 10 min before and after each patient received either normal saline (NS group; n = 10) or isoproterenol 5 micrograms (ISO group; n = 10) iv. The data-collecting investigator and a nurse palpating the patient's radial artery determined which solution they thought had been administered. The authors analyzed the maternal heart rate tracings using baseline-to-peak (a greater than or equal to 25 beat/min maternal heart rate increase occurring within 120 s of drug injection and lasting greater than or equal to 15 s) and peak-to-peak (a greater than or equal to 10 beat/min increase in the maximum maternal heart rate during the 2-min postinjection over the maximum maternal heart rate during the 2 min preinjection) criteria for detection of an intravascular marker. Mean maternal heart rate in the ISO group was significantly higher than in the NS group 20, 30, 40, 50, and 60 s following the injection (P less than 0.01). The peak-to-peak criterion and the data-collecting investigator correctly classified all patients. Five ISO group patients were not identified by the baseline-to-peak criterion. The nurse palpating the mother's radial artery misidentified two patients. Systolic blood pressure was significantly higher in ISO group than in NS group patients 1 min (P less than 0.05) and 2 min (P less than 0.01) following drug injection. Diastolic and mean blood pressures did not change. No fetal distress occurred. Isoproterenol 5 micrograms is an effective marker of intravascular injection in laboring women; however, the safety and efficacy of epidural isoproterenol must be demonstrated in animals before isoproterenol can be incorporated in an epidural anesthesia test dose.

Anesthetics, Local↗
PubMed1988

Results of 317 contraction stress tests with controlled nipple stimulation using an electric breast pump.

Nipple stimulation is widely used for producing uterine contractions. High rates of hyperstimulation have been reported with various manual methods of stimulation. A study was undertaken in an effort to standardize the mode and amount of stimulation. Three hundred seventeen contraction stress tests were done using an automatic electric breast pump with precise pressure control. This method was successful in achieving adequate contractions in 84.2%. Hyperstimulation of the uterus was encountered in 4.1% of all tests performed. Side effects and complications were minimal.

Breast↗
PubMed1987

Effect of route of delivery on periventricular/intraventricular hemorrhage in the low-birth-weight fetus with a breech presentation.

Ninety-two consecutive cases of breech presentation with birth weights less than or equal to 2,000 g were examined for early periventricular/intraventricular hemorrhage (PV/IVH) and neonatal demise. The total group and subgroups, based on birth weight and gestational age, showed significantly less early PV/IVH and perinatal mortality if delivered by cesarean section. There is a need for a prospective, randomized, multicentric study of this subject.

Breech Presentation↗
PubMed1987

Serum prolactin levels during contraction stress test done by the breast pump.

Maternal serum prolactin (PRL) levels were evaluated in patients having contraction stress tests (CST) by nipple stimulation. Of 79 CSTs, 14 failed and 65 were successful. Poststimulation PRL levels in failed cases were significantly lower than those in gestational age-matched successful cases, despite longer duration of nipple stimulation in the failed cases.

Breast↗
PubMed1987

Method and route of delivery in the low birth weight vertex presentation correlated with early periventricular/intraventricular hemorrhage.

Two hundred eighty patients with vertex presentation who were in spontaneous labor and delivered neonates weighing 2 kg or less were examined for early ultrasound evidence of periventricular/intraventricular hemorrhage. This was correlated retrospectively with delivery route (cesarean section versus vaginal delivery) and delivery method (low forceps delivery versus normal spontaneous delivery) in the group born vaginally. No correlation was evident between early periventricular/intraventricular hemorrhage and delivery route or method.

Apgar Score↗
PubMed1986

Use of the Greenfield filter for thromboembolic disease in pregnancy.

Recent technical advances in surgical intervention for thromboembolic disease have made the Greenfield filter a safe and effective treatment when heparin is contraindicated or recurrent emboli develop. One successful use of Greenfield filter placement in pregnancy has been reported. We report six additional cases. Maternal morbidity was negligible, and fetal outcomes were good. The use of the Greenfield filter as an adjunctive therapy for treatment of severe thromboembolic disease in pregnancy appears to be safe and should be considered in appropriate candidates.

Adult↗
PubMed1986

Correlation of fetal heart rate monitoring and acid-base status with periventricular/intraventricular hemorrhage in the low birthweight neonate.

We investigated the correlation of fetal heart rate patterns and fetal acid-base findings with the occurrence of early periventricular/intraventricular hemorrhage and variants. Ninety-five consecutive singleton neonates with birthweights less than or equal to 2000 gm were investigated. One-third of them showed early periventricular/intraventricular hemorrhage or variants. Fetal heart rate scores and umbilical arterial/venous acid-base status showed no correlation with results of scanning. The implications of these findings are discussed.

Acid-Base Equilibrium↗
PubMed1986

Fetal heart rate changes and uterine activity during coitus.

Fetal heart rate and uterine activity were monitored during sexual intercourse in three otherwise normal gravid women at varying gestational ages. Increased uterine activity and a variety of fetal heart rate changes, some of which are traditionally identified as ominous, were seen in most instances immediately following orgasm. An increase in fetal activity was also commonly reported by the mothers. It is postulated that coitus is equivalent to an unmonitored contraction stress test.

Adult↗