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Biomedical subjects

F R Witter

Publications and source records attributed to F R Witter.

At least 55 records · Page 3Linked to original sources
PubMed1991

Population differences affect nonstress test reactivity.

The nonstress test (NST) is the most widely used test of fetal well-being. Recently it has been suggested that race may play a role in NST reactivity. The objective of this research was to explore population variables in addition to race that may influence NST reactivity. Study subjects were 1263 black and 658 white women who underwent NST in the week preceding delivery at a tertiary facility. Retrospective analysis of data from a comprehensive database was conducted. It was found that the percentage of black women with a nonreactive NST was more than three times the percentage of white women, and that from 35 weeks' to 42 weeks' gestation there were significantly fewer reactive NSTs for blacks than for whites (P less than .05). Racial differences in NST results persisted in a logistic regression analysis controlling for several population variables including pregnancy complications and demographic and behavioral factors (odds ratio 3.81; 95% CI 3.03 to 4.78). Regression analysis also confirmed that gestational age, maternal education, epilepsy, and smoking significantly influenced NST reactivity. These results indicate that population differences in NST reactivity exist at our facility. Further prospective study of population determinants of NST reactivity is needed to determine how race, test indication, and other clinical, demographic, and behavioral variables should be used in interpretation of tests of fetal well-being. Standard criteria for NST testing may not be useful in all obstetrical populations.

Black People↗
PubMed1990

Postinjection kinetics of antepartum Rh immune globulin.

The disappearance kinetics of a standard dose of 300 micrograms of Rh immune globulin given at 28 weeks' gestation was investigated. Ten Rh-negative unsensitized women were given 300 micrograms of Rh immune globulin at 28 weeks and blood samples were drawn at weekly intervals until delivery. Sera were titrated with Ror red blood cells in a saline solution-antiglobulin method. Titers ranged from 1 to 4 by the first week after injection. In nine of 10 patients the titers were zero at 49 to 70 days after injection. With R2R2 red blood cells and LISS, papain, polybrene, or a combination of methods, Rh immune globulin could still be detected until delivery in four of the nine patients. Because these serologic methods can detect 5 ng/ml anti-D, five of 10 subjects may not have been protected for 8 to 29 days before delivery. This study indicates that a titer of less than or equal to 4 is expected for passively acquired anti-D during pregnancy, and that antepartum administration of Rh immune globulin may not always produce detectable passive antibody for as long as theoretically predicted.

Female↗
PubMed1990

Intrauterine growth retardation: characteristics, risk factors and gestational age.

Maternal, obstetrical, and neonatal factors were studied in 1604 pregnancies complicated by intrauterine growth retardation and 1604 non-IUGR controls. These were examined in the overall IUGR group and at various gestational ages. Eighty-six percent of perinatal deaths were found in the IUGR group with 57.4% occurring prior to labor. Maternal smoking, low weight gain, low prepregnancy weight, and hypertension were found more frequently in the IUGR population. In addition, maternal hypertension was found to be significant in the IUGR infants delivered prematurely.

Adult↗
PubMed1990

Marijuana use in pregnancy and pregnancy outcome.

A retrospective analysis utilizing historical data collected as part of our computerized data base was performed to assess the impact of marijuana use in pregnancy on pregnancy outcome. Records of 8350 patients were reviewed and 417 patients gave a history of only marijuana use for a prevalence of 5%. There was no association between marijuana use and prematurity or congenital anomalies. Marijuana use was strongly associated with the use of alcoholic beverages and smoking. Previously reported associations may represent the concomitant use of these other drugs.

Alcohol Drinking↗
PubMed1989

Cervical examination prior to induction in postdate pregnancies.

Results from cervical examination prior to induction of labor at 42 weeks of completed gestation differed significantly between those patients in whom delivery was by cesarean section and those in whom delivery was vaginal. The absolute value of the difference was small, however, and the overlap between the two groups was so great that it was not clinically useful. Cervical examination prior to induction was a poor screening test for determining those patients in whom delivery would ultimately be by cesarean section.

Cervix Uteri↗
PubMed1988

Abnormal glucose screening in pregnancy in patients with normal oral glucose tolerance tests as a screening test for fetal macrosomia.

Minor abnormalities of carbohydrate metabolism in pregnancy are a risk factor for delivery of a macrosomic infant. However, the 50-g 1-h oral glucose screen at 28 weeks is not a useful screening test for macrosomia in pregnant patients with normal glucose tolerance tests, because a positive screen does not raise the probability of delivering a macrosomic infant sufficiently to warrant intervention.

Cross-Sectional Studies↗
PubMed1988

The effect of maternal age on primary cesarean section rate.

A retrospective analysis of computerized data from 11,815 patients with no history of previous cesarean section revealed an increasing primary cesarean section rate with increasing maternal age. This increase occurred over the entire reproductive age span. Fetal distress as an indication for primary cesarean section may account for this increase.

Adult↗
PubMed1988

Pharmacodynamics and tolerance of oral sustained release ritodrine.

A new oral sustained release formulation of ritodrine was tested for patient tolerance in this open study. The doses tested were 120 mg/day, 240 mg/day, and 360 mg/day. No objective toxicity was seen at any level. Doses of 120 mg/day and 240 mg/day were well-tolerated. Of the subjects who received the 360 mg/day dose, most tolerated it well.

Administration, Oral↗
PubMed1988

Effects of prednisone, aspirin, and acetaminophen on an in vivo biologic response to interferon in humans.

In healthy volunteers receiving a single intramuscular dose of 18 X 10(6) U interferon alone or after 24 hours of an 8-day course of prednisone (40 mg/day), aspirin (650 mg every 4 hours), or acetaminophen (650 mg every 4 hours), the magnitude of the biologic response to interferon was quantified by measuring the time course of the induction of 2'-5'-oligoadenylate synthetase and resistance to vesicular stomatitis virus infection in human peripheral blood mononuclear cells. Prednisone decreased the AUC of 2'-5'-oligoadenylate synthetase activity (p less than 0.05), whereas administration of aspirin or acetaminophen did not affect this biologic response. No measurable effect was seen during administration of prednisone, aspirin, or acetaminophen on the duration or intensity of vesicular stomatitis virus yield reduction. The side effects seen with interferon administration at the dose tested were not altered in a clinically meaningful manner by prednisone, aspirin, or acetaminophen.

2',5'-Oligoadenylate Synthetase↗
PubMed1987

A randomized trial of induction at 42 weeks gestation versus expectant management for postdates pregnancies.

A randomized prospective clinical trial of induction of labor at 42 completed weeks gestation versus expectant management in postdates pregnancies was performed. The primary screening test was the 24-hr urinary estriol creatinine ratio. The cesarean section rate was high in both groups and did not differ statistically. Intervention by delivery at 42 weeks decreased the development of small for gestational age infants, but costs slightly more. Twenty-four-hour urinary estriol creatinine ratio determinations predicted fetal distress in labor, but could not predict postmaturity syndrome or infants who were small for gestational age. As expectant management did not differ from induction of labor at 42 weeks from the standpoint of maternal outcome, and as the cost difference was small, induction of labor at 42 weeks may be the preferred management as it improves infant outcome.

Cesarean Section↗
PubMed1987

Time course of interferon levels, antiviral state, 2',5'-oligoadenylate synthetase and side effects in healthy men.

The kinetics of the biologic response following a single intramuscular injection of 18 X 10(6) units of recombinant human interferon-alpha 2a (rHuIFN-alpha 2a) was investigated during 11 courses in 10 healthy individuals. Serial peripheral blood mononuclear cell (PBM) samples were assayed for their biologic responsiveness to rHuIFN-alpha 2a by measuring both their 2',5'-oligoadenylate (2-5A) synthetase activity and their resistance to in vitro vesicular stomatitis virus (VSV) infection. A significant increase in 2-5A synthetase levels occurred at 6 h, and enzyme levels returned to baseline values between 96 and 104 h postinjection. Protection of PBMs from VSV infectivity began within 1 h and lasted up to 144 h postinjection. The clinical side effects induced by IFN administration and serum IFN levels were not parallel over time with the antiviral effects observed. This study defines the time course of the biologic response induced by rHuIFN-alpha 2a in healthy volunteers. A parallel time course between the induction of 2-5A synthetase activity and the development of the antiviral state in PBMs was demonstrated.

2',5'-Oligoadenylate Synthetase↗
PubMed1986

Neonatal outcome after indomethacin treatment for preterm labor.

Forty-six infants exposed to indomethacin in utero for treatment for preterm labor were compared with infants from two control groups. In one control group the next consecutive patient treated with a tocolytic agent was used, and the other control group was formed by picking the next consecutive patient matched by gestational age who did not receive any tocolytic agent. There was no significant difference in Apgar scores, birth weight, or gestational age in the three groups. The incidence of neonatal complications including hypocalcemia, hypoglycemia, respiratory distress syndrome, patient ductus arteriosus, sepsis, and neonatal mortality were not significantly different in the three groups. No cases of premature closure of the ductus arteriosus or persistent fetal circulation were seen.

Apgar Score↗