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Biomedical subjects

D A Sacks

Publications and source records attributed to D A Sacks.

31 records · Page 2Linked to original sources
PubMed1986

Blood transfusion and Jehovah's Witnesses: medical and legal issues in obstetrics and gynecology.

Jehovah's Witnesses are members of a religious denomination whose beliefs prohibit the use of blood or blood products. Plasma volume expanders and extracorporeal hemodilution of the patient's own blood are theologically acceptable. Acute massive hemorrhage in which only blood is lifesaving may be encountered in obstetrics and gynecology. Either withholding or administering blood in such circumstances may have legal consequences for the physician and hospital. Factors to be considered include fetal viability, the presence of dependent children, and rules of informed consent. Whenever possible, the potential for transfusion should be anticipated and clearly discussed with the patient. When appropriate, the physician and hospital should move rapidly to obtain judicial resolution.

Blood Transfusion↗
PubMed1985

Isoimmunization in pregnancy to Gerbich antigen.

A case of hemolytic disease of the newborn due to Gerbich, a public antigen, is presented. The antibody which was IgG1 reacted in vitro with mononuclear phagocytes. Serial sonographic and amniotic fluid examinations were followed and a mildly jaundiced neonate was delivered. Further investigation may establish a relationship between severity of disease and IgG subclasses, a mononuclear phagocyte assay, and sonographic measurements. Sources of compatible blood for possible maternal, fetal, or neonatal transfusion include blood bank rare donor files, relatives, and autologous donation.

Adult↗
PubMed1983

Yta isoimmunization in pregnancy. A case report.

A case of isoimmunization with anti-Yta occurred. Despite transplacental passage of IgG antibody, no hemolysis of fetal cells was noted. The potential for hemolysis of cells transfused to an adult is unclear. Alternatives exist for securing compatible cells for possible maternal transfusion.

Adult↗
PubMed1980

Sinusoidal fetal heart rate pattern with intrapartum fetal death.

A case of sinusoidal fetal heart rate pattern with intrapartum fetal death is presented. This pattern has been observed infrequently during both the antepartum and intrapartum periods. Not all sinusoidal patterns may be ominous. A reasonable plan of management includes maternal position change, oxygen administration, scalp sampling and preparation for immediate delivery.

Adult↗
PubMed1976

The effect of drugs on uterine activity.

Uterine activity was measured for a 30-minute preinjection period and a 30-minute postinjection period for six drugs commonly used in labor. Uterine activity was quantitated by measuring the area below the uterine pressure curve with an on-line technic utilizing a voltage control oscillator. Uterine activity readings were obtained every 2.5 minutes and reported in uterine activity units (UAU). Unmedicated labor demonstrated a relatively static increase in UAU per unit of time in labor. On comparing total UAU before and after injection, only magnesium sulfate was noted to cause a decrease in total UAU. Utilizing 10-minute summations of UAU, the pre- and postinjection periods were compared to the calculated expected UAU for the 30 minutes following the preinjection period (assuming no drug had been used). For each of the other drugs, the positive slope of the calculated expected UAU shifted to a negative slope of the actual observed UAU following drug administration.

Adolescent↗
PubMed1975

Significance of meconium during labor.

Continuous fetal heart rate (FHR) monitoring and routine fetal scalp blood sampling was utilized in the evaluations of 366 fetuses during labor. One hundred and six patients had meconium in the amniotic fluid at some time during labor. A total of 26,110 uterine contractions were monitored during these 366 labors. The incidence of FHR patterns as a percentage of uterine contractions was calculated for the meconium and nonmeconium groups. Although there was a 3 1/2-fold increase in the incidence of low five-minute Apgar scores (less than 7) in the meconium group, signs of fetal distress were, with rare esception, not significantly different from those in the nonmeconium group. The presence of meconium in the amniotic fluid without signs of fetal asphyxia (late decelerations and acidosis) is not a sign of fetal distress and need not be an indication for active intervention. The combination of fetal asphyxia and meconium staining of the amniotic fluid, however, does enhance the potential for meconium aspiration and a poor neonatal outcome. Universal fetal heart rate monitoring and appropriate fetal acid-base evaluation is recommended for following patients with meconium in the amniotic fluid during labor.

Acid-Base Equilibrium↗