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Biomedical subjects

F G Mariona

Publications and source records attributed to F G Mariona.

At least 19 recordsLinked to original sources
PubMed1990

Management of preterm labor patients at home: does daily uterine activity monitoring and nursing support make a difference?

Daily home uterine activity monitoring and perinatal nursing support were compared with standard care in managing patients with recurrent preterm labor during the current pregnancy in an effort to reduce preterm birth. Sixty-seven successfully treated preterm labor patients were randomly assigned in this multicenter study to daily home uterine activity monitoring and perinatal nursing support or to a standard-care group. Recurrent preterm labor occurred in 15 (45%) of monitored patients and 19 (56%) of standard-care patients. The risk of preterm birth (before 37 weeks) for patients with recurrent preterm labor was significantly reduced (P = .025) in the monitored group (seven, or 47%) compared with the standard-care group (16, or 84%). The relative risk of delivering because of failed tocolysis was 2.8 for the standard-care group versus the monitored group. There were no patients in the monitored group who delivered at the first recurrence of preterm labor for failed tocolysis. The data suggest that home uterine activity monitoring and perinatal nursing support are helpful in achieving term birth through earlier detection and treatment of recurrent preterm labor.

Adult↗
PubMed1988

Anesthesia-related maternal mortality in Michigan, 1972 to 1984.

We reviewed maternal deaths in the state of Michigan occurring from 1972 through 1984. There were 15 maternal deaths in which anesthesia was considered the primary cause and 4 deaths in which anesthesia was a contributory factor. Complications of regional anesthesia were the main cause of death during the early part of the period, whereas the inability to accomplish endotracheal intubation emerged as the principal cause of death in recent years. Eleven of the 15 patients had undergone cesarean section. Obesity was a risk factor in 12 patients, in an equal number of patients the risk factor was the emergent nature of the operation, and hypertensive disease was a risk factor in eight. Thirteen of the 15 deaths occurred in black patients.

Adolescent↗
PubMed1987

Preeclampsia, delivery, and the hemostatic system.

To determine the effects of preeclampsia and delivery, the hemostatic system was evaluated before and 24 to 48 hours after delivery in 59 nulliparous patients without clinical signs of disseminated intravascular coagulation. Fifteen patients with mild preeclampsia and 18 with severe preeclampsia were compared with 26 pregnant control patients. Preeclampsia was associated with high fibronectin (p less than 0.001), low antithrombin III (p less than 0.001), and low alpha 2-antiplasmin (p less than 0.005), suggesting endothelial injury, clotting, and fibrinolysis, respectively. After delivery, fibronectin decreased only in preeclamptic patients (p less than 0.005); alpha 2-antiplasmin increased in all groups (p less than 0.001). Endothelial injury in preeclampsia appeared to resolve soon after delivery, which could contribute to the rapid clinical improvement noted in the early puerperium.

Adult↗
PubMed1987

The use of clinical, biochemical, and ultrasound parameters for the diagnosis of intrauterine growth retardation.

Fifty-four pregnant patients referred for nonstress testing with findings suggestive of intrauterine growth retardation (IUGR) were followed with serial biochemical determinations and ultrasound evaluations. Confirmation of IUGR was made in 18 of the neonates based on body weights below the 10th percentile. Stepwise discriminate function analysis was used to determine the factors most predictive of IUGR among several clinical, biochemical, and ultrasound parameters as well as their combinations. Only the determinations closest to the time of delivery were used in analysis. The presence of abnormal fetal ultrasound measurements had the highest predictive value. Prepregnancy weight improved the prediction slightly with a proportion of correct predictions increasing from 70 to 74%. Only the extremes of prepregnancy weight altered the prediction made on the basis of ultrasound. In contrast, no significant predictive value was demonstrated for weight gain, heavy cigarette smoking, hypertension, serum estriol, human placental lactogen, alpha-fetoprotein, or a decrease in amniotic fluid volume, either singly or in combination with other variables.

Amniotic Fluid↗
PubMed1987

Management of uterine hyperstimulation after prostaglandin E2 administration.

Recent literature suggests that intravaginal or intracervical application of prostaglandin E2 gel may be an effective agent for cervical ripening. One potentially disastrous reported side effect is uterine hyperstimulation. This case report represents the first description of the successful management of uterine hyperstimulation with intravenous ritodrine therapy after the intravaginal administration of prostaglandin E2.

Administration, Intravaginal↗
PubMed1986

Fetal alpha-melanocyte-stimulating hormone levels: no correlation with late fetal growth but increased with diabetes mellitus.

The pars intermedia of the fetal pituitary produces alpha-melanocyte-stimulating hormone. Previous reports suggest that alpha-melanocyte-stimulating hormone may be a determinant of early fetal growth in animal models. Based on anencephalic fetuses, a similar role was suggested in humans. To examine its relationship to late human fetal growth, alpha-melanocyte-stimulating hormone levels were measured by radioimmunoassay in 185 umbilical cord blood samples from anatomically normal fetuses of 28 to 42 weeks' gestation. With use of stepwise multiple regression analysis, no significant relationship was demonstrated between alpha-melanocyte-stimulating hormone levels and fetal growth. However, significantly higher levels were found in infants of diabetic mothers (p less than 0.05) independent of birth weight, gestational age, or both. No significant relationship with other maternal factors related to fetal growth, labor, and delivery was demonstrated. We conclude that fetal plasma alpha-melanocyte-stimulating hormone levels do not correlate with late human fetal growth. It is speculated that increased alpha-melanocyte-stimulating hormone levels among infants of diabetic mothers might be related to altered neurological maturation.

Birth Weight↗
PubMed1986

Prenatal diagnosis and outcome of congenital complete heart block: the role of fetal echocardiography.

Between January 1, 1980, and March 1, 1986, congenital complete heart block (CCHB) was diagnosed in 11 fetuses utilizing 2-dimensional and M-mode fetal echocardiography. Four of the eleven cases (36.4%) had otherwise structurally normal hearts; 3 survived the perinatal and neonatal period and 1 patient died at 22 days of age. All mothers in this group had systemic lupus erythematosus. Seven of the eleven fetuses (63.6%) presented with CCHB and associated cardiac malformations. All patients in this group died either in utero or shortly after birth. The discovery of CCHB with associated structural malformations of the heart carries an ominous prognosis for fetal and neonatal survival. The diagnosis of CCHB without associated cardiac malformations carries a more favorable outlook. Accurate prenatal diagnosis of CCHB and underlying cardiac status facilitates parental counseling and patient management planning.

Adult↗
PubMed1986

Effect of porcine relaxin on the human umbilical artery.

Relaxin decreases human myometrial contractions in vitro; that effect is synergized by progesterone. We examined the effects of porcine relaxin on the contractility of isolated perfused human umbilical arterial strips in vitro. One experimental group received relaxin (1.5 micrograms/mL), the second received progesterone (500 ng/mL) plus relaxin, and the control strips received neither. Both resting and agonist-stimulated (KCl or serotonin) isometric tension were compared with profile analysis for all groups. Relaxin had no effect on either resting or agonist-stimulated tension either with or without progesterone. Neither higher concentrations of relaxin nor longer exposures altered contractility. Therefore, the human umbilical artery, unlike the cervix and myometrium, is not sensitive to porcine relaxin. Porcine relaxin could be used as a tocolytic or cervical ripening agent without adversely affecting fetal placental circulation.

Animals↗
PubMed1984

Maternal serum alpha-fetoprotein (MSAFP) and fetal growth.

Early mid-trimester screening of maternal serum alpha-fetoprotein (MSAFP) for the detection of neural tube defects is becoming a routine part of obstetrical care. In singleton pregnancies in the absence of fetal chromosomal abnormalities and anatomical anomalies high levels of AFP have been variably related to increased risk for low birthweight infant outcome. The overall relationship, if any, of maternal serum AFP to infant birthweight has, however, not been previously characterized. Between 15 and 20 weeks gestation, MSAFP values were determined for 110 women carrying single, anatomically and karyotypically normal fetuses. Statistical analysis utilizing polynomial and multilinear regression was used to determine the relationship of early mid-trimester MSAFP first to neonatal birthweight and then to gestational age and birthweight adjusted for gestational age. For every increase of one multiple of the median in MSAFP, neonatal birthweight fell 322 grams. This was accounted for almost entirely by decreased fetal growth; early mid-trimester MSAFP was linearly related to birthweight adjusted for gestational age ten times more strongly than to gestational age alone. The explanation for this relationship remains speculative, but the utility of routine AFP screening for the antenatal detection of intrauterine growth retardation certainly deserves further study.

Birth Weight↗
PubMed1983

Profile of phospholipids in amniotic fluid to assess fetal lung maturity in high-risk pregnancy.

In assessing fetal lung maturity, an amniotic fluid profile, consisting of a total phospholipid (as phosphorus) (TPP) and total lecithin (LT) concentration, has been shown to yield a predictive accuracy of 97.5% with a false-negative rate of 2.4%. The LT had a range of specificity of 93% to 99%, whereas the one for the TPP was 88% to 96%. The cut-off values were 0.14 mg P/dl and 3.5 mg lecithin/dl of amniotic fluid. The analytical variables for laboratory tests for measuring amniotic fluid phospholipids led to the development of the quantitative tests used for this study. The proposed profile appears to offer the clinician an excellent means of judging how to manage the high-risk pregnancy.

Amniocentesis↗
PubMed1982

Pregnancy following repair of anal and vaginal atresia and bladder exstrophy.

Pregnancy following surgical correction of bladder exstrophy with anal and partial vaginal atresia is extremely rare. These defects, plus the absence of the pubic symphysis and anatomic deficiencies of the urogenital diaphragm, pose extraordinary obstetric and surgical problems. This report is based on the experience of a 21-year-old patient who had successful pregnancy following curative repair of these defects. Progressive uterine prolapse occurred during pregnancy to the extent that at the time of delivery the presenting part of the fetus was below the pelvic outlet. Cesarean section was performed at 36 weeks' gestation when the cervix was 4 cm dilated with a single footling breech presentation. Postpartum surgical management of the uterine and vaginal prolapse is described.

Adult↗
PubMed1981

Prenatal diagnosis of fetal megabladder and urethral agenesis.

This is a case report of antenatal ultrasonographic detection of an enlarged fetal urinary bladder. Serial sonographic examinations revealed a large unilocular fetal intraabdominal mass. Cystocentesis and amniocentesis under ultrasonic control were preformed as well as an amniogram to establish the diagnosis. This is the fourth reported case in the English literature of fetal urethral agenesis diagnosed during the prenatal period. Early detection of potentially lethal fetal malformations is feasible with detailed examination of fetuses at risk.

Adult↗
PubMed1980

Clostridium perfringens septicemia following cesarean section.

A Clostridium perfringens infection is described in an 18-year-old primigravida following cesarean section at 43 weeks' gestation. Despite the ubiquitous distribution of these organisms, such infections are rarely encountered in obstetrics. Characteristics of these bacteria and appropriate diagnostic and therapeutic procedures are presented. Despite the infrequency of this potentially lethal complication, survival depends on early diagnosis and aggressive treatment.

Adolescent↗