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H F Andersen

Publications and source records attributed to H F Andersen.

At least 37 records · Page 2Linked to original sources
PubMed1990

Histidine-rich glycoprotein inhibits contact activation of blood coagulation.

Histidine-rich glycoprotein has been purified from bovine plasma employing two different purification procedures. The first procedure was one-step ion-exchange chromatography using phosphocellulose, while the second procedure involved fractionation using polyethyleneglycol 6000 followed by column chromatography employing CM-Sepharose and heparin-Sepharose. The effect of purified bovine histidine-rich glycoprotein on the contact activation of blood coagulation was studied in human plasma by using as activating surface either an ellagic acid-phospholipid suspension (Cephotest) or sulfatide. Contact activation was monitored by the generation of amidolytic activity towards a synthetic chromogenic substrate (S-2302) for factor XIIa and plasma kallikrein. Bovine histidine-rich glycoprotein inhibits the contact activation induced by both of these activating surfaces.

Amino Acid Sequence↗
PubMed1990

Prediction of risk for preterm delivery by ultrasonographic measurement of cervical length.

Risk assessment for preterm delivery remains difficult, particularly among women with no prior history of preterm birth. We hypothesized that accurate assessment of cervical length by endovaginal ultrasonography could predict preterm delivery risk. A total of 178 patients with singleton gestations and without cervical incompetence were studied with transabdominal ultrasonography and endovaginal ultrasonographic cervical length measurement and manual vaginal examination of cervical length. A total of 113 patients who were evaluated by 30 weeks' gestation (excluding four induced preterm deliveries) were analyzed. Preterm delivery risk was compared between women with cervical lengths equal to or greater than the median and those with cervical lengths less than the median. An endovaginal ultrasonographic cervical measurement less than 39 mm was associated with a significantly increased risk of preterm delivery (25.0% versus 6.7%) and detected 76% of preterm births. Manual examination of cervical effacement detected 71% of preterm births, but transabdominal ultrasonographic measurement of cervical length was not preditive. Endovaginal ultrasonographic cervical measurement predicted increased preterm delivery risk regardless of parity or obstetric history. Endovaginal ultrasonography is a promising method for the prediction of risk of preterm birth. Because it has the potential to be an objective measure of cervical length, endovaginal ultrasonography may be superior to manual digital examination for preterm delivery risk assessment.

Cervix Uteri↗
PubMed1990

Lifestyle modification as an intervention for inner city women at high risk for preterm birth.

This study details a programme which emphasized nursing interventions for women at high risk for preterm birth. Preterm birth continues to be a major health problem, with ongoing research being conducted both in the United States and internationally in an effort to find causative factors. Programmes designed to prevent preterm birth have been described often in the literature, with lifestyle factors being implicated in the incidence of preterm birth by many researchers. The purpose of this study was to determine the lifestyle factors most often associated with preterm birth in a high risk population of inner city women, and to examine the effect of change in lifestyle when change was possible. Women at high risk for preterm birth were interviewed extensively for prevalence of 12 lifestyle factors most often cited in the literature as being associated with preterm birth. Counselling and education were offered to each woman, with emphasis on symptom recognition and modification of lifestyle activities. Comprehensive prenatal care was administered by programme personnel. A profile of the women's reported lifestyle activities and stress factors is presented along with the relationship to outcome. The data suggested that, when change in lifestyle activity or stress was possible, women who decreased the activity or stressor were more likely to deliver at term. This study represents one of the first efforts in the United States to produce a prospective database to quantify risk and analyse the impact of change in activities associated with symptoms of preterm labour in high risk women.(ABSTRACT TRUNCATED AT 250 WORDS)

Counseling↗
PubMed1990

A "PROPP" for the Bronx: preterm birth prevention education in the inner city.

As one component of the multifaceted community-wide preterm prevention program known as "A PROPP for the Bronx" (Program to Reduce Obstetric Problems and Prematurity), a prenatal education videotape in both English and Spanish was developed. Its impact was evaluated in 615 high-risk patients at the Bronx Municipal Hospital Center. The 12-minute videotape focused on the implications of preterm birth, the signs and symptoms of preterm labor, and behavioral modification to reduce life-style risk factors. An instrument was constructed to examine baseline knowledge, information transfer, and knowledge retention, and was validated and tested for reliability (r = 0.95). The results demonstrated a statistically significant knowledge transfer for patients viewing the videotape (P less than .0001) and significant knowledge retention through the postpartum period (P less than .0001) for Spanish-speaking as well as English-speaking parturients. These data emphasize the importance of the educational component of a preterm prevention program in an impoverished population at risk for early delivery.

Adolescent↗
PubMed1989

Court-ordered cesarean section: an analysis of ethical concerns in compelling cases.

Two previously unreported cases are presented in which court-ordered cesarean sections were considered appropriate by physicians. An analysis of the factors that compel physicians to deem court-ordered intervention appropriate is presented. When the significance of a third-trimester fetal death or a lifetime physical or mental disability is balanced against the demand to uphold maternal autonomy at all costs, the recognized ethical principles of beneficence, nonmaleficence, justice, obstetric contract keeping, and acting in the patients' best interests combine, in rare situations, to override concerns for individual maternal autonomy and justify court-ordered intervention.

Adult↗
PubMed1989

Effectiveness of patient education to reduce preterm delivery among ordinary risk patients.

Patient education is an important component of all preterm birth prevention programs, but studies of these programs have not examined the independent contribution of patient education to preterm birth prevention. The Program to Reduce Obstetrical Problems and Prematurity in the Bronx, New York, is a multifaceted preterm birth prevention program that includes a half hour combined videotape and nurse discussion session, which was offered to all patients. In evaluating the outcome of pregnancies in patients not at high risk for preterm delivery (ordinary risk patients) we found that patients who received instruction to recognize early signs of preterm labor had babies with a higher birthweight (3255 +/- 548 gm) than patients who were not so instructed (3200 +/- 599 gm, p = 0.03). Average length of gestation in the instructed and noninstructed patients was 276 +/- 15 days and 275 +/- 18 days (p = 0.12), respectively. The preterm delivery rate among patients receiving the instruction was 9.5% compared with 11.5% among those who did not receive it. We conclude that specific prenatal education about early warning signs of preterm labor is an important component of preterm birth prevention programs that can be demonstrated to have an independent contribution to prenatal care.

Adult↗
PubMed1987

Utility of a sensitive bedside serum pregnancy test.

We compared the performance characteristics of a rapid qualitative serum pregnancy test with a standardized quantitative assay for human chorionic gonadotropin in the evaluation of women with suspected ectopic pregnancy. At a threshold value of 25 mIU/mL, the rapid assay demonstrated a sensitivity of 100% and a specificity of 96%.

Adolescent↗
PubMed1987

Neonatal status in relation to incision intervals, obstetric factors, and anesthesia at cesarean delivery.

Uterine incision to delivery interval has been suggested as a critical determinant of neonatal outcome; however, studies of skin incision and uterine incision to delivery intervals have usually not analyzed the contribution of obstetric factors relative to time factors in determining outcome. A group of 204 patients undergoing cesarean delivery were studied. Stepwise multivariate regression was used to examine the relative contribution of obstetric and anesthetic factors to Apgar scores and umbilical cord blood gases. Apgar scores and umbilical cord blood gases were significantly influenced by labor complications (fetal distress, meconium, and pre-eclampsia), infant weight, type of cesarean delivery (primary vs. repeat), and type of anesthesia. Skin incision and uterine incision to delivery intervals did not significantly contribute to Apgar scores nor umbilical cord blood gases when corrected for these factors. We conclude that careful attention to maternal status prior to cesarean delivery and optimal anesthetic management appear to be the most important factors for good neonatal outcome. Surgical techniques should be directed at gentle, atraumatic delivery of the fetus for the good of the fetus and the mother.

Anesthesia, Obstetrical↗
PubMed1987

Disseminated herpes simplex infection in an immunocompromised pregnancy: treatment with intravenous acyclovir.

In this article, we report a case of third-trimester disseminated herpes simplex virus (HSV) infection in an immunocompromised gravida who was treated with parenteral acyclovir. Rapid resolution of lesions occurred, and the fetus was delivered at term without evident abnormalities. Of the four previous reports on this therapy, there has been one maternal death and survival of all neonates. Acyclovir should be considered in the treatment of disseminated HSV infection in pregnancy.

Acyclovir↗
PubMed1981

Gestational age assessment. II. Prediction from combined clinical observations.

Accurate assessment of the estimated date of confinement is a cornerstone of obstetric care. In an earlier report, we examined the time of occurrence of various historical and clinical estimators of gestational age in relation to the date of delivery. We now examine the possibility of combining multiple clinical estimators to improve the prediction of delivery date. Formulas for predicting delivery date from multiple clinical estimators were developed in a group of 418 patients who were delivered of infants weighing greater than or equal to 3,000 gm, after spontaneous onset of labor. These formulas were tested in a separate group of 107 patients who fulfilled similar criteria. In patients with a known last menstrual period, additional clinical information did not improve the prediction of delivery date; however, if the last menstrual period was uncertain or unknown, averaging the predicted delivery dates by several clinical examinations provided a prediction of delivery date as precise as if the last menstrual period were known.

Female↗
PubMed1981

Gestational age assessment. I. analysis of individual clinical observations.

Accurate assessment of the estimated date of confinement is a cornerstone of obstetric care. Traditionally this date has been predicted from historical and clinical examinations; however, there have been few studies of the accuracy of such predictions. Multiple estimators of gestational age were examined in 418 patients who were delivered of infants weighting larger than or equal to 3,000 gm, following spontaneous onset of labor. Mean intervals from an event to delivery were calculated for last menstrual period (284.2 days), quickening (156.3 days), first audible fetal heart tones (136.2 days), uterine fundus at the umbilicus (140.8 days), and measurements of the fundal height. The variability in each of these estimators was examined and compared. The last menstrual period, if known with certainty, is the most accurate estimator, followed by the uterus at the umbilicus, first heard fetal heart tones, fundal height, and quickening.

Adolescent↗
PubMed1980

Adult respiratory distress syndrome in obstetrics and gynecology.

The diagnosis, pathophysiology, and treatment of adult respiratory distress syndrome (ARDS) are discussed and 2 cases are presented. ARDS has varied etiology but common clinical, roentgenographic, and pathologic findings; it has been increasingly recognized as an important cause of morbidity and mortality in seriously ill patients. The obstetrician-gynecologist must be aware of this condition, for survival depends upon prompt diagnosis and meticulous therapy of the condition and its underlying cause.

Adult↗
PubMed1980

Cesarean section: indications and postoperative morbidity.

Over an 18-month period, the cesarean section rate was 21.6%. THe primary cesarean section rate was 14.9%. The various indications for the primary cesarean section are detailed. Cephalopelvic disproportion and breech presentation accounted for 50% of the primary cesarean sections. The frequencies of various types of morbidity (ie, endometritis, wound infection, and urinary tract infection) are presented and analyzed with respect to several variables. Patients who underwent primary cesarean section were at significantly greater risk of developing postoperative endometritis than were patients undergoing a repeat procedure. Labor, ruptured membranes, and the use of internal fetal-maternal monitoring were not significant risk factors for endometritis in the patients in this study.

Cesarean Section↗
PubMedDate not supplied

ESTAGEST: an obstetrical application program in BASIC for the computation of estimated date of confinement.

The establishment of the estimated date of confinement (EDC) is an essential element in the care of pregnant women. Unfortunately, accurate information on the last menstrual period, the usual determinant of EDC, is not always available, or clinical estimations of gestational age may be discrepant. Prior studies have demonstrated that an average of several clinical examinations can provide a useful prediction of EDC. We have developed a simple BASIC computer program which allows the clinician to input up to 20 clinical examinations and determines the average EDC based on the clinical dates. The program displays the EDC for each individual examination, which provides an indication of the dispersion, or discrepancy, among the examinations. Average intervals to delivery date from the occurrence of clinical estimators of gestation are based on observed data at our institution and can be easily modified to fit local norms.

Algorithms↗
PubMedDate not supplied

What pregnant women want to know: a comparison of client and provider perceptions.

OBJECTIVE: To compare client and health-care provider perceptions concerning health topics. DESIGN: A survey conducted at the first prenatal visit asked women to indicate levels of interest in 38 topics. Providers answered the same survey, indicating perceptions of clients' interests. SETTING: A prenatal clinic and a private office, both in an inner city area. PARTICIPANTS: Two groups of prenatal clients (n = 135 private care and n = 250 public care) and their health-care providers (n = 32 nurses and physicians). RESULTS: Significant differences were found (p < .01 for four topics, p < .05 for six topics) between the clients' interests and the providers' perceptions. Women in private and public care differed significantly (p < .01) in their levels of interest. Interest was significantly affected by parity, but not maternal education. CONCLUSIONS: Nurses and other health professionals should be aware of the range of topics in which clients express interest. This study suggests that site of care and parity should be considered when developing prenatal health education.

Adolescent↗