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Biomedical subjects

D A Edelman

Publications and source records attributed to D A Edelman.

At least 109 records · Page 6Linked to original sources
PubMed1976

Factors affecting intrauterine contraceptive device performance. I. Endometrial cavity length.

The relationship of endometrial cavity length to intrauterine contraceptive device (IUD) performance was evaluated in 319 patients wearing three types of devices. The rate of events, defined as pregnancy, expulsion, or medical removal, increased significantly when the length of the IUD was equal to, exceeded, or was shorter by two or more centimeters than the length of the endometrial cavity. Total uterine length was found to be a less accurate prognostic indicator of IUD performance than endometrial cavity length alone.

Adult↗
PubMed1976

A standard of fetal growth for the United States of America.

The appropriate interpretation of monitored fetal growth throughout pregnancy in individual patients and populations is dependent upon the availability of adequate standards. There is no adequate standard of fetal weight throughout pregnancy that is suitable for patients in the U.S.A. To determine such a standard for infants delivered at about sea level the 10th, 25th, 50th, 75th, and 90th percentiles of fetal weight for each menstrual week of gestation were calculated from 430 fetuses at 8 to 20 menstrual weeks' gestation aborted with prostaglandins and from 30,772 liveborn infants delivered of patients at 21 to 44 menstrual weeks' gestation. Median fetal crown-to-rump lengths and crown-to-heel lengths were derived from measurements of 496 aborted fetuses of 8 to 21 weeks' gestation. Fetal weight correction factors for parity, race (socioeconomic status), and fetal sex were calculated. The derived fetal growth curves are useful for clinical, public health, and investigational purposes.

Body Height↗
PubMed1976

A comparative study of intra-amniotic saline and two prostaglandin F2alpha dose schedules for midtrimester abortion.

The efficacy, side effects, and complications of two intra-amniotic PGF2alpha dose schedules and the unaugmented intra-amniotic instillation of saline are compared. All three methods resulted in satisfactory rates of abortion within a relatively short period of time and within clinically acceptable rates of complications. Each method has its advantages and disadvantages. Further large comparative studies were needed.

Abortion, Induced↗
PubMed1976

Laparoscopic sterilization in the immediate puerperium.

The safety and effectiveness of laparoscopic sterilization with electrocoagulation and separation of the tubes when performed within five days of a normal delivery is evaluated. The majority of patients (53.5%) were sterilized within 36 hours of delivery and were discharged on either the same day or the first post-sterilization day (91.0%). While some form of complications were reported for 9.5 percent of the patients, potentially serious complications occurred for only 2 patients (1.%). Most of the complications were probably unrelated to the laparoscopic procedure. At six months after sterilisation, complications were reported by 2.9 percent of the patients who returned for a follow-up visit. One patient became pregnant 3.5 months after sterilization. The results of this study suggest that performing laparoscopic sterilization in the immediate puerperium does not significantly increase the complication or failure rates of the procedure.

Electrocoagulation↗
PubMed1976

Midtrimester abortion: a comparison of intraamniotic prostaglandin F2alpha and hypertonic saline.

The safety and effectiveness of two intraamniotic prostaglandin F2alpha (PGF2alpha) dose schedules (a single 50 mg dose and a repeated 25 mg dose) and intraamniotic hypertonic saline were evaluated in a study where each abortion procedure was randomly assigned to 50 patients. All patients were at 16 to 20 weeks' gestation. Rates of gastrointestinal and other side effects were generally higher for the 50 mg PGF2alpha dose schedule than for the other two procedures. The repeated 25 mg PGF2alpha dose schedule resulted in higher 24-hour (68.0%) and 48-hour (98.0%) cumulative abortion rates than the 50 mg PGF2alpha dose schedule (54.0%, 92.0%) or saline (34.7%, 91.8%). Rates of spontaneous placental expulsion were highest for the repeated 25 mg PGF2alpha dose (74.0%) and lowest for the 50 mg PGF2alpha dose schedule (40.0%).

Abortion, Induced↗
PubMed1976

An assessment of the side effects of switching from one oral contraceptive to another.

Side effects associated with three oral contraceptives were evaluated in a study in which women were switched to Norlestrin 1 from either Ovral (64 subjects) or Norinyl 1/50 (26 subjects). In the cycle prior to crossover, breast discomfort was more frequent among Norinyl users than among Ovral users. The prevalence of all other reported side effects was not significantly different for Norinyl and Ovral. The crossover to Norlestrin did not significantly change the numbers of patients reporting side effects. By the end of third Norlestrin cycle, rates of all side effects were similar for women who were switched from either Ovral or Norinyl.

Contraceptives, Oral↗
PubMed1976

Practicability of ultrasonography for assessing fetal age and weight in early pregnancy.

This study was conducted to evaluate (1) the feasibility and accuracy of the B-Scan technique for measuring biparietal diameter (BPD) in utero, (2) the accuracy of the B-Scan technique for predicting fetal age and weight, and (3) parameters of fetal growth in pregnancies of less than 21 weeks's gestation. Forty-one subjects underwent diagnostic ultrasonography before induction of therapeutic abortion with Prostaglandin F2alpha. Following abortion, fetal crown-to-rump length (CRL), crown-to-heel (CHL), BPD, and fetal weight were measured directly. After 13 menstrual weeks' gestation the BPD could be accurately measured by ultrasound. The relationship of BPD to gestational age and fetal weight and the indices of fetal growth as measured by the CRL and CHL were established. It is concluded that ultrasound is a useful adjuvant to clinical assessment of fetal age and weight in patients form 13 to 21 menstrual weeks' gestation.

Body Height↗
PubMed1976

Female sterilization using the tubal ring.

The surgical and early postoperative complications were evaluated in a study of 221 laparoscopies and 29 minilaparotomies in which tubal occlusions were performed with the application of tubal rings. For either procedure, complications were infrequent. None of the procedures had to be completed by another technique of tubal occlusion, and none of the patients required an extended hospitalization for the treatment of a complication. Among the 79 patients who have been followed up for more than 6 months, no pregnancies have been reported. The tubal ring technique appears to be safe and effective when used with either laparoscopy of minilaparotomy.

Adult↗
PubMed1976

Repeated extra-amniotic administration of prostaglandin F2alpha for midtrimester abortion.

Midtrimester abortion was induced in 94 of 100 patients at 16 to 24 weeks' gestation by the extra-amniotic administration of 1170 microng of prostaglandin F2alpha (PGF2alpha) every 10 minutes. The number of prostaglandin doses varied from 16 to 24 depending on the patient's response to the prostaglandin. The median abortion time was 10.0 hours, and 82.0% of the patients aborted within 24 hours. Overall, 68.0% of the patients failed to expel the placenta within one hour of abortion of the fetus. Vomiting and diarrhea occurred among 42.0 and 17.0% of the patients, respectively. Compared with the intra-amniotic administration of a single 50 mg dose of PGF2alpha, the extra-amniotic procedure was associated with similar side effect rates, a higher rate of incomplete abortion, and a significantly shorter abortion time.

Abortion, Induced↗
PubMed1976

Amniotic fluid removal prior to saline abortion.

To evaluate whether removal of the amniotic fluid prior to the instillation of 200 ml of 20% hypertonic saline has any effect on the success, speed, and safety of the abortion process, 192 patients at 15--20 weeks' gestation were aborted according to one of the following procedures: 1) instillation of 200 ml saline without removal of the amniotic fluid (92 subjects), 2) removal of 100 ml of amniotic fluid prior to saline instillation (46 subjects), and 3) removal of 150 ml of amniotic fluid prior saline instillation (54 subjects). The study indicated that there are no apparent advantages to the removal of the amniotic fluid prior to the instillation of 200 ml of hypertonic saline. The median times from instillation to abortion and rates of incomplete abortion were similar for the three groups of patients. Rates of specific complications, except for fever, were similar for the three groups.

Abortion, Induced↗
PubMed1976

Laparoscopic sterilization with electrocautery, spring-loaded clips, and Silastic bands: technical problems and early complications.

Among 2283 patients, rates of technical failure, technical difficulty, and operative and early postoperative complications were evaluated for different methods of tubal occlusion at laparoscopy: electrocoagulation (980 cases), spring-loaded clip application (991 cases), and Silastic band application (312 cases). Rates of technical failure and technical difficulty at surgery were significantly higher (P less than 0.05) for the spring-loaded clip technique than for the electrocoagulation and Silastic band techniques. Mechanical and optical difficulties with the prototype spring clip applicator were the major sources of technical difficulties. Rates of operative (1.2%) and early postoperative (1.9%) complications were not significantly different for the three techniques of tubal occlusion. It is concluded that all three study techniques appear to be practical, and large, long-term, randomized, comparative studies to determine rates of failure and subsequent gynecologic problems are necessary to determine the best method of sterilization.

Electrocoagulation↗
PubMed1976

Early termination of pregnancy: a comparative study of intrauterine prostaglandin F2alpha and vacuum aspiration.

The relative safety and effectiveness of vacuum aspiration and the intrauterine administration of 5 mg PGF2alpha for terminating pregnancies within two weeks of a missed menstrual period were evaluated in a study where subjects were randomly assigned to procedures; 100 patients were aborted with vacuum aspiration and 100 patients were aborted with PGF2alpha. All PGF2alpha-treated patients were premedicated with meperidine, diazepam and atropine. Complications were infrequent with either of the procedures. Vomiting occurred more frequently during the PGF procedure (30.0%) than during the vaccum aspiration procedure (9.0%). The intrauterine instillation of PGF2alpha successfully terminated all pregnancies. One patient continued to be pregnant after the vacuum aspiration procedure. Based on the results of this study both study procedures appeared to be safe and effective for terminating early first trimester pregnancies.

Abortion, Induced↗
PubMed1976

Amniotic fluid removal prior to saline abortion.

To evaluate whether removal of the amniotic fluid prior to the instillation of 200 ml of 20% hypertonic saline has any effect on the success, speed, and safety of the abortion process, 192 patients at 15-20 weeks' gestation were aborted according to one of the following procedures: 1) instillation of 200 ml saline without removal of the amniotic fluid (92 subjects), 2) removal of 100 ml of amniotic fluid prior to saline instillation (46 subjects), and 3) removal of 150 ml of amniotic fluid prior saline instillation (54 subjects). The study indicated that there are no apparent advantages to the removal of the amniotic fluid prior to the instillation of 200 ml of hypertonic saline. The median times from instillation to abortion and rates of incomplete abortion were similar for the three groups of patients. Rates of specific complications, except for fever, were similar for the three groups.

Abortion, Induced↗
PubMed1975

Fetal crown-rump length and biparietal diameter in the second trimester of pregnancy.

This study examines the relationships between fetal size (biparietal diameter and crown-rump length) and gestational age among subjects aborted by hypertonic saline in the second trimester of pregnancy. With a confidence of 90 per cent, biparietal diameter can be used to predict gestational age within plus or minus 2 weeks, and crown-rump length can be used to predict gestational age within plus or minus 3 weeks.

Abortion, Induced↗