Biomedical subjects

E H Bishop

Publications and source records attributed to E H Bishop.

17 recordsLinked to original sources

PubMed1982

Management of the latent phase of labor.

1. Iatrogenic causes of prolonged latent phase such as sedation, narcotic analgesia, and epidural anesthesia should be avoided during the latent phase. 2. Cesarean delivery is not appropriate management solely for failure to progress in latent phase. 3. Multiparas in latent phase with favorable cervices should be treated with oxytocin stimulation. 4. Multiparas with unfavorable cervices and most nulliparas should be treated with therapeutic rest when they become exhausted during a long latent phase, without regard to an arbitrary time table. 5. Characteristics of latent phase in induced labors are undefined. 6. Management of latent phase in the presence of ruptured membranes should take into consideration the total clinical picture, including gestational age, presentation, and risk of infection and other pertinent factors.

Female↗

PubMed1981

Fetal acceleration test.

Five hundred thirty-one fetal acceleration tests were performed on 112 normal subjects at various gestational ages ranging from 22 and 41 weeks. Analysis of the results revealed that the frequency of nonreactive tests was directly related to gestational age, ranging from 56% in the 22- to 25-week group to 6% in the 38- to 41-week group. During the same period 919 fetal acceleration tests were performed on 339 high-risk subjects. When these were divided into groups by gestational age, the frequency of nonreactive tests did not differ significantly from that in the normal group of subjects. These dats suggest three possible conclusions: (1) that the high frequency of false positive results does not justify the performance of utilization of such tests before 30 weeks' gestational age; (2) that nonreactivity is probably a function of gestational age rather than an indication of fetal jeopardy; (3) that the frequency of "false positive" tests among the normal population may invalidate reliance on such tests for management of subjects in a high-risk category.

False Positive Reactions↗

PubMed1981

Acceleration of fetal pulmonary maturity.

Neonatal pulmonary complications attributable to pulmonary immaturity are among the more serious problems attending premature birth. Various observations indicate that glucocorticoids play an important role in the maturation of the fetal lung. Moreover, prenatal maternal administration of corticosteroids has been attended by significantly improved neonatal outcome, including a reduction in the incidences of respiratory distress syndrome (RDS), hyaline membrane disease, and mortality due to intraventricular hemorrhage. Success of treatment is related directly to gestational age, with best results occurring between 30 and 32 weeks' gestation. Significant effects have been reported as early as 28 weeks' and as late as 34 weeks' gestation. The potential maternal and neonatal risks of this therapy have not yet been established. Animal studies using relatively high doses of corticosteroids have resulted in an inhibition of deoxyribonucleic acid (DNA) synthesis and mitosis, leading to profound complications and a rise in fetal mortality. Although follow-up of human subjects has been limited and of short duration, no consistent postnatal effects have been noted. The apparent lifesaving benefits of the treatment, combined with only rare and usually correctable fetal, neonatal, and maternal complications, indicate that the use of corticosteroids for prevention of neonatal respiratory problems may be an important advance in reproductive medicine. It remains to be established, however, what the optimal agent and dose are, and what, if any, are the long-term effects of this therapy.

Adrenal Cortex Hormones↗

PubMed1978

Prophylactic antibiotics in high-risk cesarean section.

A brief perioperative course of ampicillin was recommended for high-risk patients undergoing cesarean section at our institution. High-risk patients were defined as those with two or more of the following factors: general anesthesia, obesity, hematocrit less than or equal to 30%, and labor prior to delivery. Fifteen percent of high-risk patients who received prophylactic antibiotics experienced postoperative febrile morbidity compared to 63% for the high-risk untreated group (P less than 0.001). Twenty-five percent of low-risk patients (less than 2 risk factors) developed this complication. Endometritis was the leading cause of postoperative febrile morbidity. Postoperative stay was only slightly decreased in the prophylactically treated group (5.9 vs 6.2 days). Prophylactic amplicillin given perioperatively was an effective agent in reducing post-cesarean-section febrile morbidty among high-risk patients.

Ampicillin↗

PubMed1978