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Biomedical subjects

C D Sims

Publications and source records attributed to C D Sims.

30 records · Page 2Linked to original sources

Prospective study of different methods and routes of administration of prostaglandin E2 to improve the unripe cervix.

Methods of vaginal and extra-amniotic prostaglandin administration to achieve ripening of the cervix as a preliminary to induction of labour are described. Three groups of twenty patients with unfavourable induction features were studied, each receiving prostaglandin E2 the evening prior to planned induction. One group received PGE2 500 micrograms suspended in a viscous medium extra-amniotically. One group received PGE2 3 mg suspended in a viscous medium into the vaginal vault. A third group received a 3 mg PGE2 vaginal pessary to the posterior fornix. Improvement in cervical status at time of induction occurred in all groups but no single group had a significant advantage when regarding mean improvement, the induction-delivery interval or the number of patients in whom labour began before formal induction. However, with regard to relative cost, ease of preparation and storage, as well as patient and medical staff convenience, Prostaglandin E2 in pessary form is a superior form of administration.

Cervix Uteri↗

Routine induction of labour with extra-amniotic prostaglandin E2 in a viscous gel.

Prostaglandin E2, 350 microgram dispersed in a viscous gel, tylose, was introduced into the extra-amniotic space as a single dose in 285 patients to induce labour. With a favourable cervix, 82 per cent of multiparae and 50 per cent of primiparae were successfully induced. With unfavourable induction features, the success rates were 48 per cent and 24 per cent respectively. In the remaining patients, all but four were successfully delivered when intravenous oxytocin was also used. The method was safe, simple and inexpensive and had many advantages for patients and nursing staff.

Amnion↗

A comparison of salbutamol and ethanol in the treatment of preterm labour.

Intravenous salbutamol and ethanol were compared as treatments for preterm labour, 42 patients being assigned randomly to salbutamol and 46 to ethanol. There was no statistically significant difference in outcome between patients in the two groups, the mean delay in delivery achieved being 15 days with salbutamol and 20 days with ethanol. Neither treatment was very effective since only 10 patients given salbutamol and 14 given ethanol had their delivery postponed to 37 weeks or later. Salbutamol was more rapidly acting than ethanol but produced more cardiovascular side effects.

Albuterol↗

Lung function tests in bronchial asthma during and after pregnancy.

Respiratory function tests (forced vital capacity and forced expiratory volume in one second) were performed serially in pregnancy, the puerperium, and at least six weeks post partum in 27 patients with a history of asthma and in 12 control subjects. Eleven asthmatic patients with spirometric evidence of respiratory obstruction in pregnancy on at least one occasion were considered to have active disease. This group had significantly impaired respiratory function tests when compared to controls. The remaining 16 asthmatic patients were considered to be in remission. No changes in respiratory function tests attributable to pregnancy could be demonstrated in the asthma or control groups. Patients with active asthma tended to have smaller babies than patients with asthma in remission or the control patients.

Apgar Score↗

The lecithin/sphingomyelin (L/S) ratio in twin pregnancies.

The lecithin/sphingomyelin (L/S) ratio has been estimated in the amniotic fluid from 20 patients with a twin pregnancy. The values in each pair of amniotic fluids were closely related. If amniotic fluid from one sac only is available, it is suggested that a ratio of 2-5:1 is taken as the lower limit to predict the functional lung maturity of both twins.

Amniotic Fluid↗

Prolonged general anesthesia for experimental craniofacial surgery in fetal swine.

A protocol utilizing high preoperative doses of altrenogest (Regu-Mate) and a "balanced" general anesthesia regimen consisting of isoflurane at subanesthetic doses supplemented with intravenous doses of sodium thiopental was developed to prevent preterm labor, minimize intracranial fetal cerebral edema, and decrease postpartum mortality of fetal swine after undergoing complex in utero craniofacial procedures. A total of 20 fetal piglets at 75% gestation were exposed to prolonged (> 3 h) anesthesia conditions of which 7 piglets were randomly selected to undergo experimental craniofacial procedures consisting of periosteal stripping of frontal and parietal bone segments with/without extensive coronal suture fusion procedures. Neither sows nor piglets were lost to anesthetic complications during the initial laparotomy or subsequent cesarean delivery. None of the sows experienced uterine sepsis or underwent preterm labor. The overall survival rate for all piglets exposed to prolonged anesthesia conditions was 95% at 4 weeks and 45% at 11 weeks after surgery. The experimental group's survival was 85.7% at 4 weeks and 28.5% at 11 weeks after surgery.

Anesthesia, General↗

Prolonged survival in fetal rabbit surgery.

Timing and outcome of antenatal surgical intervention is being explored using fetal animal models. Models that are currently used range from larger animals with fewer offspring and higher cost to smaller animals with larger litters and lower cost. The rabbit is an ideal "small" animal model for experimentation in the third trimester, with a large litter, short gestation and a relatively large fetus. This paper reports methods by which prolonged survival (greater than 110 days) may be achieved in as many as 60% of operated fetuses following complex fetal surgery in the rabbit.

Animals↗