[Prophylactic antibiotics in caesarean section].
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Biomedical subjects
Publications and source records attributed to E Caspi.
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The rationale for undertaking the present study was to evaluate the utility of iodoestradiol analogs made highly radioactive with iodine isotopes in (a) the non-invasive differentiation of estrogen-dependent from estrogen-independent breast tumors, (b) spread of metastases containing estrogen receptors, and (c) potential application in therapeutic irradiation of target tissues. In the present paper, the model syntheses of a number of nonradioactive 127I-estrogen analogs are described. The analogs were tested for their ability to displace (compete with) [3H]estradiol from receptor sites. The most active compounds, 16beta-iodoestra-1,3,5(10)-triene-3,17 beta-diol (17) and 6-iodoestra-1,3,5(10),6-tetraene-3,17 beta-diol (10b), showed a relative binding affinity of 0.57 and 0.49, respectively.
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The effect of intravenous administration of ritodrine on blood glucose, insulin, free fatty acids and electrolytes in 17 third-trimester gravidas was investigated. A highly significant increase in blood glucose, insulin and free fatty acids and a marked decrease in serum potassium levels were registered. No significant changes during ritodrine infusion were recorded in serum levels of sodium, chloride, calcium, phosphorus and magnesium. No cardiac arrhythmias or electrocardiographic deteriorations occurred. While intravenous ritodrine administration seems to be safe in normal pregnancy, there may be a risk in diabetic patients, digitalized cases and those patients being treated with diuretics.
Four cases of erythema nodosum associated with pregnancy are reported and the literature reviewed. Erythema nodosum in pregnancy is a self-limited condition requiring minimal supportive treatment. No adverse effects upon pregnancy course or fetal outcome were noted. It is suggested that pregnancy may serve as an etiological basis for the disease.
In only a few studies of reconstructive surgery for infertility has the importance of periadnexal adhesions been examined with regard to the pregnancy rate. In the present study, 101 patients underwent reconstructive surgery for correction of infertility. Subsequent to surgery, 38.6% of the patients conceived, and 72% of the pregnancies terminated in live births. In analyzing the results, attention was focused upon the correlation between the severity of the periadnexal adhesions and the surgical outcome. By classifying the adhesions into four grades, an inverse relationship was noted between the grade of adhesions and the pregnancy rate. This relationship was consistent regardless of tubal condition, and thus became an important prognostic parameter. In the light of these findings it is felt that, in order to improve the results, more effort should be directed to the prevention of adhesion formation, together with the use of microsurgical technique in this particular field.
The influence of prenatal and continuous postnatal protein-restricted diet on the development of rats was investigated. Virgin female rats were maintained for 35 days on isocaloric diets containing 8 or 25% casein, and then mated. The animals were supplied their respective diets during gestation and nursing. It was observed that the offspring of mothers kept on the 8% casein diet had 50% less body weight, and 10-15% less brain weight than the corresponding controls. The peak of rapid brain growth for both groups of animals occurred at age 6 days. The rate of de novo biosynthesis of sterols, following the injection of (2-14C)-mevalonic acid into the midline thalamic area and the cerebellum, was also investigated. A significant shift of the age of peaking of 14C-incorporation into sterols in the cerebellum was noted. Our results indicate that although unlimited amounts of food were supplied to the mothers on the 8% casein diet, this could not offset the detrimental effect of the protein deficiency on the offspring.
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The effects of a controlled sodium bicarbonate (SB) infusion on the acid-base balance of the primiparous mother and fetus at labor and delivery were evaluated. Two identical groups of primiparas with normal labor and delivery were studied. According to acid-base parameters observed in the mothers and fetuses of a control group, the pharmacologic dynamics, and the space of distribution of SB, 2 mEq/1 kg of total body weight were administered to the mothers of the study group, beginning at a cervical dilation of 6 cm until full dilation occurred. Highly significant changes in pH, base excess (BE), and plasma bicarbonate were observed in both the mothers and fetuses. In the latter, the significant changes appeared after a time lag of about 2 hours. No adverse effects in the mothers and fetuses were observed. The significant reduction of the relative fetal acidosis by the controlled SB infusion justifies further studies on the therapy potentials of this method in high-risk deliveries and during intrapartum fetal distress.
This is a retrospective review of 494 deliveries during a 10-year period in women aged 40 or more years. A decline in the incidence of deliveries in this age group was noted, from 2.1% in 1965 to 1.2% in 1974. An increased frequency of complications during pregnancy and delivery, a high rate of cesarean sections, and increased perinatal mortality rate, and more congenital malformations were recorded as compared with both a control group of randomly selected grand multiparas and a general obstetric population group of patients under the age of 40 years. The fetal outcome improved during the last years of the study; the perinatal mortality rate dropped from 10.4% in 1965 to 1.6% in 1973 to 0% in 1974. This achievement reflects the significant progress in obstetrics that has been made during these years.
Twenty-four conservative surgical procedures for unruptured tubal pregnancies were performed on 23 patients with poor past obstetric performance. All cases were diagnosed preoperatively by laparoscopy. Salpingotomy was performed in 20 cases and fimbrial expression of the ectopic pregnancy was performed in 4 cases. In the group of conservatively treated patients there were 15 live births in 11 women and 28 intrauterine pregnancies in 14 women. No ectopic pregnancies occurred in the operated tube. Early diagnosis and conservative surgical treatment of unruptured tubal pregnancy is appropriate for patients with poor reproductive histories.
The present study was undertaken to establish accurate, convenient, simple and rapid ultrasonographic measurements of fetal parameters and their correlation with gestational age and fetal weight. Relationship with gestational age was studied in 60 fetuses from 348 measurements of the biparietal diameter (BPD) and was also correlated with eight other parameters. There is no doubt that the BPD is the most reliable parameter for estimation of gestational age. In 34 infants, 306 measurements of nine fetal parameters taken within four days before delivery were correlated with their birth weights. Abdominal area gave the highest correlation, compared with other parameters or their combinations. Since combined measurements of several parameters gave only a slightly higher multiple correlation (R = 0.89) with fetal weight than the measurement of abdominal area alone (r = 0.85), their use is not justified as a routine procedure.
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Listeriosis during pregnancy is generally considered to result in an intrauterine infection which affects the fetus before birth or in the perinatal period. A case of listeriosis in a 38-yr-old diabetic woman with an influenza-like disease in her 32nd wk of pregnancy is presented. Two successive blood cultures were positive for Listeria monocytogenes type 4b and her serum showed a rising titer for agglutinins to this organism. After antibiotic treatment of the patient she gave birth to a healthy child.
The benefit of fetal heart rate monitoring was evaluated by comparing the perinatal outcome in 1.246 high-risk pregnancies and deliveries--554 monitored and 692 unmonitored. Intrapartum and early neonatal mortality were significantly lower in the monitored group (P less than 0.05). This study provides evidence that fetal heart rate monitoring improves the fetal outcome of high-risk deliveries.