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Biomedical subjects

G E Knox

Publications and source records attributed to G E Knox.

At least 37 records · Page 2Linked to original sources
PubMed1984

In-utero transport.

In-utero transport has become an indispensible component of regionalized perinatal care. Successful implementation of a transport program, while requiring a high degree of professional and institutional cooperation, can produce enormous patient care dividends. Optimal survival at minimal cost is clearly possible in regionalized systems characterized by appropriate in-utero and infant transport. Given optimal circumstances, previously held contraindications to in-utero transport appear to decrease or disappear. Thus, in the context of a regionalized network, in-utero transport is the standard of care that should be offered to all infants at risk.

Delivery, Obstetric↗
PubMed1983

Absorbance of amniotic fluid at 650 nm as a fetal lung maturity test: a comparison with the lecithin/sphingomyelin ratio and tests for disaturated phosphatidylcholine and phosphatidylglycerol.

We compared absorbance of amniotic fluid at 650 nm (A650) against the lecithin/sphingomyelin ratio, the quantity of disaturated phosphatidylcholine, and the presence or absence of phosphatidylglycerol in 374 uncontaminated amniotic fluid samples. In addition, we studied these measures of fetal lung maturity in 80 pregnancies where neonatal outcomes were known. Statistical analysis revealed a significant association between increasing absorbance and biochemical indices of lung maturation. Our results indicate that A650 of amniotic fluid is useful as a measure of lung maturity but that the greatest utility may be for samples with either low absorbance (less than 0.10) or high absorbance (greater than 0.20). Because of large false positive and false negative values between these two absorbances, other lung maturity estimates should be used when absorbances fall within this range. Therefore, A650 may be most useful as a screen or as part of a battery of lung maturity estimates. We are exploring these possibilities as a means of providing better fetal lung maturity estimates.

Amniotic Fluid↗
PubMed1983

C-reactive protein with premature rupture of membranes and premature labor.

C-reactive protein (CRP) was determined serially in 31 patients with premature rupture of the membranes, 41 patients in premature labor, and 18 pregnant patients with a variety of high-risk conditions. Elevated levels of CRP were not predictive of clinical amnionitis, histologic chorioamnionitis, or neonatal sepsis. No discernible relationship was found between serum CRP and peripheral white blood cell count. CRP was not elevated (false negative) in two patients in the premature labor group with culture-proved bacterial amnionitis. Elevated CRP in the absence of infection (false positive) likewise occurred. The results suggest that CRP be used in conjunction with other signs and symptoms suggestive of chorioamnionitis, rather than as a pathognomonic test.

C-Reactive Protein↗
PubMed1979

Management of prolonged pregnancy: results of a prospective randomized trial.

Prolonged pregnancy was rigorously defined in 180 gravid women without other complications. Patients were randomly assigned to be serially followed, either by amniocenteses or by oxytocin challenge tests (OCT's). Induction of labor, based upon only (1) a finding of meconium in the amniocentesis group or (2) a positive test in the OCT group, was nearly three times more frequent in the amniocentesis group. The incidence of meconium, which overall was 22% initially and 44% at delivery, as well as the frequencies of obstetric and perinatal complications, were similar in both management groups. Although meconium was significantly associated with abnormal labor progression, intrapartum fetal distress, and low 1 and 5 minute Apgar scores, induction of labor after discovery of meconium, when compared to nonintervention, did not improve perinatal outcome. It is concluded that a search for meconium is of little value in the management of prolonged pregnancy.

Amniocentesis↗
PubMed1979

Comparative prevalence of subclinical cytomegalovirus and herpes simplex virus infections in the genital and urinary tracts of low-income, urban women.

The prevalence of subclinical infections caused by cytomegaloviruses (CMV) and herpes simplex viruses (HSV) was assessed simultaneously in the genital and urinary tracts of 1,101 indigent women. Shedding of CMV from the genital and urinary tracts exceeded that of HSV by ninefold (8.89% vs. 0.95) and sevenfold (3.8% vs. 0.51%), respectively. Pregnancy, regardless of gestational age, had no discernible influence on productive infection with either virus in either the genital or the urinary tract. In contrast, age was a significant variable, especially with CMV. The prevalence of CMV shedding decreased steadily with age, from peak values of 15% and 8% in the genital and urinary tracts, respectively, of females 11-14 years of age to undetectable levels in females 31 years of age and older. Productive HSV infection was more prevalent in postmenopausal than in premenopausal women: 2.4% vs. 0.8% and 3.1% vs. 0.2% in the genital and urinary tracts, respectively. Likewise, HSV infection of both the genital and the urinary tract combined was more common in older than in younger females.

Adolescent↗
PubMed1979

Association of extrauterine fetal death with failure of prostaglandin E2 suppositories.

The use of prostaglandin E2 vaginal suppositories is an effective method of uterine evacuation for patients with intrauterine fetal demise. Advanced extrauterine gestation, because of its rarity, is usually not a primary consideration for patients presenting with fetal death. This report presents 4 such cases and strongly suggests that, when this drug is used for the treatment of fetal death, failure to induce contractions and to effect uterine evacuation within a reasonable time should prompt the consideration of extrauterine pregnancy.

Abortion, Induced↗