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Biomedical subjects

B Furman

Publications and source records attributed to B Furman.

17 recordsLinked to original sources
PubMed1998

Meconium stained amniotic fluid in very low risk pregnancies at term gestation.

OBJECTIVE: To determine the prevalence and clinical significance of meconium stained amniotic fluid (MSAF) in a low risk population at term gestation and to investigate whether MSAF is a predictor for intrapartum and neonatal morbidity. METHODS: A very low risk population including 37 085 consecutive deliveries at term composed the study population. A cross-sectional study was conducted and two groups of patients were identified according to the presence (n=6164) or absence (n=30921) of meconium in the amniotic fluid at delivery and the outcomes of the two groups compared. RESULTS: The prevalence of MSAF was 16.6%. The incidence of cesarean section (5.6% vs 2.3% P<0.01), instrumental deliveries (3.2% vs 1.8% P<0.01), fetal distress (6.5% vs. 2.1% P<0.01), clinical chorioamnionitis (0.2% vs. 0.1% P<0.01), post-partum infection (0.5% vs. 0.2% P<0.01), 1-minute Apgar score <3 (1.9% vs. 1.1% P<0.01), small for gestational age (7.4% vs. 6.4% P<0.01). was significantly higher in the MSAF compared with the clear amniotic fluid group. Intrapartum and neonatal mortality in this low risk population was significantly higher in the MSAF group (1.7/1000) compared with women with clear AF (0.3/1000). CONCLUSIONS: MSAF in a low risk population at term gestation is a predictor for adverse perinatal outcome and peripartum complications.

Amniotic Fluid↗
PubMed1998

Insulin-like growth factors, their binding proteins, and fetal macrosomia in offspring of nondiabetic pregnant women.

The Objective of this paper is to determine the relation between fetal macrosomia in offspring of nondiabetic women, and the levels of insulin-like growth factors (IGF-I, IGF-II), insulin growth factor binding protein-3 (IGFBP-3) and insulin, in maternal and neonatal compartments. Serum samples were obtained from normal pregnant women (n = 60) and their neonates (n = 60) between 37-41 weeks' gestation (mean 39 +/- 9). Neonates were categorized as appropriate for gestational age (AGA; 10th-90th percentile; n = 20), and large for gestational age (LGA; >90th percentile; n = 40). Maternal and neonatal serum samples were analyzed for levels of IGF-I, IGF-II, IGFBP-3 and insulin, by specific radioimmunoassays (RIAs). Serum levels were correlated with birth weight. The mean birth weight of the AGA group was 3296 +/- 500 g versus 4201 +/- 300 g for the LGA group (p <0.0001). Cord blood IGF-I was statistically higher in LGA group than in the AGA infants, (139 +/- 67 ng/mL and 80 +/- 32 ng/mL, respectively; p <0.0001). There was no correlation between maternal IGF-I serum levels and birth weight (363 +/- 131 in the AGA vs. 308 +/- 158 in the LGA group). IGF-II in maternal and cord blood did not correlate with fetal weight. Cord blood IGFBP-3 was significantly higher in the LGA group (1.1 +/- 0.07 microg/mL) than in the AGA group (0.96 +/- 0.05 microg/mL; p < 0.05). Maternal insulin levels were similar between the two groups. Neonatal insulin levels were higher in the LGA group (18 +/- microU/mL) as compared to the AGA group (16 +/- microU/mL), however, this difference did not reach statistical significance. Fetal cord blood levels of IGF-I and IGFBP-3 are directly correlated with the birth weight of large for gestational age fetuses. These data suggest that the somatotropic axis plays a role in fetal growth. Additionally, insulin growth factor-1 appears to be an in utero growth promoter in the development of fetal macrosomia in infants of nondiabetic women.

Adult↗
PubMed1998

Cytokines in preterm parturition.

We have proposed a model in which the initiation of human parturition in the presence of infection is mediated by the host response. Systemic infections such as pyelonephritis, or localized intrauterine maternal infections such as deciduitis and cervicitis, might trigger parturition via the monocyte/macrophage system in both maternal blood and human decidua. According to this model, labor is to be considered an event that occurs when the intrauterine or maternal environment is hostile to the well-being of the fetus, as was supported by recent studies. From this point of view, the initiation of preterm labor may have survival value.

Cytokines↗
PubMed1995

Maternal and perinatal outcome of patients with preterm labor and meconium-stained amniotic fluid.

OBJECTIVE: To determine the clinical significance of meconium-stained amniotic fluid (AF) observed at amniocentesis in patients with preterm labor. METHODS: A nested case-control study was constructed based on the color of AF during amniocentesis. Forty-five women admitted with preterm labor and meconium-stained AF were matched for gestational age at admission and compared with 135 women with preterm labor and clear AF. All AF samples were cultured for aerobic and anaerobic bacteria and mycoplasma. RESULTS: The rates of positive AF cultures for microorganisms, overall preterm birth (before 36 weeks), preterm birth before 32 weeks, and clinical chorioamnionitis were all significantly higher in patients with meconium-stained AF than in those with clear AF (positive AF cultures, 38 versus 11%, P < .001; preterm delivery before 36 weeks, 73 versus 41%, P < .001; preterm delivery before 32 weeks, 51 versus 17%, P < .001; and clinical chorioamnionitis, 22 versus 6%, P = .003). In contrast, no significant differences were observed between groups with respect to maternal age, gravidity, parity, abruptio placentae, placenta previa, fetal distress, cesarean rate, or puerperal morbidity. CONCLUSION: Patients with preterm labor and meconium-stained AF had higher rates of microbial invasion of the amniotic cavity, clinical chorioamnionitis, and premature deliveries than those with clear AF.

Adult↗
PubMed1988

Return of the question "why": advantages of exploring pre-existing explanations.

We suggest that there are many advantages in thoroughly exploring the causal explanations given by clients or members of their social network to account for their problems. Specific interviewing techniques are presented to uncover clients' causal explanations or their impressions about the causal explanations of others. Various advantages of exploring these explanations are discussed. They include improved cooperation, development of "systemic empathy," detachment from the explanations of other professionals, recognition and avoidance of coalitions, loosening of firmly held explanations, dilution of noxious explanations, generation of new and positive explanations toward solutions, and taking a bird's-eye view or meta position about such explanations. We conclude that acceptance and appreciation of the human tendency to believe in causal explanations is a fruitful way to enhance interaction between clinicians and clients.

Communication↗
PubMed1985

Chylomicrons from patients with type V hyperlipoproteinemia inhibit platelet function.

Platelet aggregation and [14C]serotonin release induced by collagen and also by ADP and thrombin were significantly decreased in patients with primary Type V hyperlipoproteinemia. Platelets derived from these patients lost their hyporesponsiveness to thrombin and ADP (but not to collagen) after washings and isolation from their plasma environment. On incubation of platelets derived from normolipidemic controls with plasma derived from patients, platelet aggregation and [14C]serotonin release were lowered by 20% and 30%, respectively. On incubation of these platelets with 100 mg/dl of chylomicron triglyceride, a 40% reduction in both platelet aggregation and [14C]serotonin release was observed. The inhibition of platelet activity was positively correlated with chylomicron concentration up to a concentration of 225 mg/dl by chylomicron triglyceride. In 2 patients, bezafibrate administration (600 mg/day) resulted in marked reduction of plasma triglyceride concentration and a parallel improvement in platelet function. The platelet hyporesponsiveness in patients with Type V hyperlipoproteinemia appears to be a consequence of platelet-chylomicron interaction. This depressed platelet function may be responsible for the absence of overt atherosclerosis noted in these patients.

Adenosine Diphosphate↗