Search PubMed⌕ Search

Biomedical subjects

J C Hauth

Publications and source records attributed to J C Hauth.

At least 127 records · Page 7Linked to original sources
PubMed1987

Second-stage fetal heart rate abnormalities and type of neonatal acidemia.

The type of acidemia (umbilical arterial pH less than 7.2) occurring in newborns with second-stage baseline fetal heart rate (FHR) abnormalities was evaluated in 277 term gestations. Umbilical arterial acidemia occurred in 40% of the neonates with moderate to severe bradycardia (25 of 63), in 30% with mild bradycardia (16 of 53), and in 22% with tachycardia (seven of 32), compared with only 6% (eight of 129) of those with a normal FHR (P less than .05 in each of the three comparisons). The majority (31 of 56, 55%) of the acidemic neonates had a mixed respiratory-metabolic pattern, whereas 13 of 56 (23%) had a respiratory pattern and 12 of 56 (21%) had a metabolic pattern. The mean umbilical arterial buffer deficit (mEq/L) was significantly greater (P less than .0005) in newborns with metabolic acidemia (-15.9 +/- 2.8) than in those with either mixed (-9.6 +/- 2.5) or respiratory (-6.4 +/- 1.9) acidemia. We conclude that baseline second-stage FHR abnormalities can predict which newborns are at increased risk of having umbilical arterial pH below 7.2 at birth. Selective determination of umbilical arterial pH and blood gas analysis may be useful in assessing intrapartum management retrospectively.

Acidosis↗
PubMed1987

Pulmonary edema as a delayed complication of ritodrine therapy. A case report.

Pulmonary edema occurred 24 hours after intravenous ritodrine therapy and 10 hours after subcutaneous terbutaline therapy. Standard therapy directed at volume overload quickly cleared the pulmonary congestion, and the pregnancy progressed uneventfully to term. A retrospective review incriminated transfusion therapy and volume overload as the etiology.

Adolescent↗
PubMed1987

Nuchal cords and neonatal outcome.

To assess the significance of nuchal cords, 110 affected woman-infant pairs at term gestation were compared with 110 control pairs. Newborns with a nuchal cord had an increased prevalence of umbilical artery acidemia (22 of 110 versus 13 of 110; P less than .05) and more variable fetal heart rate (FHR) decelerations in the first stage of labor (mild = 41 versus 20; P less than .0001; moderate-severe = 21 versus 5; P less than .0001) and the second stage of labor (moderate-severe = 46 versus 21; P less than .0001). In newborns with a nuchal cord, the umbilical artery acidemia was usually mixed (68%) or respiratory (23%) in origin, and pure metabolic acidemia was infrequent (9%). We conclude that nuchal cords are associated with an increased prevalence of variable FHR decelerations in the first and second stages of labor and with an increased incidence of umbilical artery acidemia.

Acidosis, Respiratory↗
PubMed1987

Effect of type of anesthesia on blood loss at cesarean section.

Halogenated anesthetic agents have been used to supplement nitrous oxide during balanced general anesthesia for cesarean delivery to decrease maternal awareness. However, these agents can interfere with uterine contractility and hence have the potential to increase blood loss at the time of cesarean section. To ascertain the effect of the addition of halogenated anesthetic agents for cesarean section anesthesia versus conduction or a simple balanced general anesthetic, we retrospectively assessed three aspects that may reflect operative blood loss at the time of cesarean section. Significantly more women whose balanced general anesthesia for cesarean section was supplemented with a halogenated agent (usually 0.5% halothane) versus those with a conduction or balanced general anesthetic required transfusion therapy, had a postpartum hematocrit less than 30 vol% and had a decrease in the pre- to postdelivery hematocrit of at least 8 vol %. The addition of halogenated anesthetic agents to a balanced nitrous oxide anesthesia for the purpose of decreased maternal awareness must be weighed against the risk incurred from the increased requirement for blood replacement and/or from postpartum anemia.

Anesthesia, Conduction↗
PubMed1987

Twins: prophylactic hospitalization and ward rest at early gestational age.

One hundred eighty-nine twin pregnancies were delivered at Wilford Hall United States Air Force Medical Center from July 1977 through December 1985. Among these, 57 were referred from distant bases and were excluded from further analysis. The remaining 132 pregnancies from our local population make up the study group. Sixty-seven women (51%) followed our advice to be hospitalized at or before 28 weeks' gestation for prophylactic ward rest. The remaining 65 women (49%) were not hospitalized until after 28 weeks' gestational age or until a pregnancy complication or labor occurred. Only three of 134 infants (2%) whose mothers were admitted died, versus 11 of 130 infants (8.5%) whose mothers were not admitted (P less than .03). The results suggest that prophylactic ward rest, implemented at or before 28 weeks' gestational age, may reduce perinatal mortality in this condition.

Bed Rest↗
PubMed1986

Genital aerobic bacterial flora of women receiving radiotherapy for gynecologic malignancy.

In the present study, genital aerobic bacterial flora was prospectively studied in 12 women receiving radiotherapy for gynecologic malignancy. Gram-positive cocci accounted for 59% and gram-negative bacilli for 27% of the 26 cervical or vaginal isolates preradiation. A similar pattern of recovery was found during external beam, 60CO whole pelvis radiotherapy. The gram-positive cocci and gram-negative bacilli accounted for 42 and 46% of the preradiotherapy rectal isolates, respectively. There was no significant change in the pattern of rectal flora during external beam radiotherapy. Thus, results from this preliminary study would indicate that external beam radiotherapy has little or no influence on the major aerobic pathogens in either the cervix, vagina, or rectum.

Adenocarcinoma↗
PubMed1986

Early repair of an external sphincter ani muscle and rectal mucosal dehiscence.

Little information is available to assist in the management of a dehiscence subsequent to a fourth degree episiotomy repair. Delayed repair of the external sphincter ani muscle and rectal mucosa may result in weeks or months of disability and inconvenience for these women. A series of eight women is presented whose fourth degree episiotomy repair dehiscence was managed by early puerperal repair. The details of wound and bowel preparation, the operative technique, and postoperative care are described. Because all eight women had a successful repair, the authors believe that early surgical correction is an acceptable treatment for this puerperal complication.

Anal Canal↗
PubMed1986

Uterine contraction pressures with oxytocin induction/augmentation.

Uterine contraction pressures were quantified (in Montetevideo units) in 109 women at term gestation who received oxytocin for induction or augmentation of labor and whose labor resulted in a spontaneous vaginal delivery. Newborn five-minute Apgar scores were greater than or equal to 8 in 108 of the 109 neonates, and no immediate neonatal morbidity was attributable to the oxytocin stimulation of labor. Women undergoing oxytocin induction had significantly greater uterine contraction pressures than those with oxytocin augmentation. During oxytocin induction 91% of women achieved at least 200 to 224 Montevideo Units and 40% at least 300 Montevideo units versus 77 and 7.7%, respectively, during augmentation of labor. With concurrent fetal monitoring these levels of uterine activity should be sought before consideration of a cesarean delivery because of presumed cephalopelvic disproportion or failure to progress.

Drug Administration Schedule↗
PubMed1985

Umbilical cord pH, PCO2, and bicarbonate following uncomplicated term vaginal deliveries.

Normal values for umbilical arterial and venous pH, PCO2, PO2, and bicarbonate must be known before these parameters can be used for assistance in clinical decisions. We evaluated the cord blood from 146 infants born after uncomplicated labor and vaginal deliveries at 37 to 42 weeks' gestation. All infants had a normal baseline fetal heart rate and normal beat-to-beat variability for at least 10 minutes preceding expulsion. The cord blood of infants born to women with pregnancy complications such as diabetes mellitus, preeclampsia, twins, meconium-stained amniotic fluid, or fetal growth retardation was not included. Mean umbilical arterial values +/- 1 SD for the parameters studied were: pH, 7.28 +/- 0.05; PCO2, 49.2 +/- 8.4 mm Hg; PO2, 18.0 +/- 6.2 mm Hg; bicarbonate, 22.3 +/- 2.5 mEq/L. Umbilical venous values were: pH, 7.35 +/- 0.05; PCO2, 38.2 +/- 5.6 mm Hg; PO2, 29.2 +/- 5.9 mm Hg; bicarbonate, 20.4 +/- 4.1 mEq/L.

Bicarbonates↗
PubMed1985

A comparison of the relative toxicities of beta-sympathomimetic tocolytic agents.

To define the relative toxicities of ritodrine sulfate, terbutaline sulfate, hexaprenaline sulfate, and ritodrine with betamethasone mongrel dogs were treated with these agents for 19 hours. The maximum dose of ritodrine was 900 microgram/min (N = 5), terbutaline 120 micrograms/min (N = 4) and hexaprenaline 1.5 micrograms/min (N = 4). Betamethasone was given intramuscularly (12 mg) at initiation of ritodrine and repeated in 12 hours in four animals. Arrhythmias were responsible for five deaths; 2/4 terbutaline, 2/4 ritodrine and beta-methasone, 1/5 ritodrine, 0/4 hexaprenaline treated animals. Terbutaline-treated animals developed arrhythmias during more treatment cycles (50%) and at lower drug concentrations, whereas hexaprenaline-treated animals developed arrhythmias at higher drug concentrations, with an overall arrhythmia frequency of 14%. Terbutaline animals had the highest heart rate (P = 0.02) and lowest mean arterial pressure (P = 0.18); the least effect on these parameters being seen with hexaprenaline. Cardiac index was higher with terbutaline and hexaprenaline compared to ritodrine with or without beta-methasone (P = 0.02). Hypoxemia was most severe with terbutaline (pO2 = 58 mm Hg) and least severe with hexaprenaline (pO2 = 66 mm Hg); however, this does not explain the difference in the frequency of arrhythmias since the mean pO2 during the initial arrhythmias was 76 mm Hg in terbutaline treated animals compared to a baseline control of 85 mm Hg. Although all animals developed significant acidosis during Phases II-IV, hexaprenaline treated animals were the least acidotic (P = 0.036). Hypokalemia was most pronounced with terbutaline (P = 0.08 Phase II, P = 0.07 Phase III).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1985

Survival and short-term morbidity of the premature neonate.

Obstetric decisions regarding premature (23 to 32 weeks' gestation) infants must be based on gestational age. However, most reports of the survival of premature infants are based on birth weight. The present report relates the perinatal survival and morbidity of 105 newborns to the obstetric gestational dating criteria between 23 and 32 weeks' gestation. Gestational age was determined from at least four obstetric criteria including the first day of the last menstrual period, early pelvic examination, the earliest auscultation of fetal heart tones with a fetoscope, fundal height measurements in centimeters between 20 and 30 weeks' gestation, and sonographic gestational age measurements. At 23 to 26 weeks' gestational age, nine (39%) of 23 neonates survived. Five of nine survivors had moderate to severe intracranial hemorrhage, three had moderate to severe bronchopulmonary dysplasia, and three had moderate to severe retrolental fibroplasia. At 27 to 29 weeks' gestational age, 25 (93%) of 27 neonates survived. Of the 25 survivors, three had moderate to severe intracranial hemorrhage, one had moderate to severe bronchopulmonary dysplasia, and one had severe retrolental fibroplasia. At 30 to 32 weeks' gestational age, 52 (95%) of 55 neonates survived. Three of the 52 (6%) survivors had serious neonatal morbidity consisting of moderate to severe intracranial hemorrhage (three neonates) and moderate to severe bronchopulmonary dysplasia (one neonate). Thus, ten of 34 (29%) survivors between gestational ages of 24 to 29 weeks had a serious morbidity versus only three of 52 (6%) survivors between 30 to 32 weeks' gestation (P less than .01).

Bronchopulmonary Dysplasia↗
PubMed1985

Term maternal and neonatal complications of acute chorioamnionitis.

One hundred and three women who developed acute chorioamnionitis at 37 weeks' gestation or beyond were studied retrospectively. Clinical findings included fever (99.2%), fetal (82%) and maternal (19.4%) tachycardia, uterine tenderness (16.5%), and foul-smelling amniotic fluid (8.7%). Three of the 46 women who underwent cesarean section subsequently required addition of a second or third antibiotic for serious pelvic infection, whereas two had a subcutaneous wound infection requiring open drainage. Importantly, between zero and ten hours of the diagnosis of chorioamnionitis, a critical time interval where delivery impacted on neonatal infectious morbidity was not identified. Additionally, in the initial 24 hours after rupture of the fetal membranes there was no association between fetal, neonatal, or maternal complications versus duration of membrane rupture. These data suggest that immediate operative delivery of term gestations complicated by acute chorioamnionitis will not reduce neonatal morbidity.

Acute Disease↗
PubMed1984

Second-stage fetal tachycardia and neonatal infection.

Forty fetuses who had mild or marked tachycardia during the final 10 minutes of the second stage of labor were evaluated for neonatal infection. Prolonged sepsis/pneumonia occurred in 10 of the 40 infants (25%), three of eight (38%) with marked tachycardia, seven of 32 (22%) with mild tachycardia, and in only one of 167 control infants who had a normal second-stage fetal heart rate (0.6%). None of the 40 women with fetal tachycardia or the 167 control subjects had any intrapartum fever or other evidence of acute chorioamnionitis. Persistent fetal tachycardia during the second stage of labor defines a population at increased risk for subsequent neonatal sepsis/pneumonia. This population will require prolonged, expert neonatal care.

Bacterial Infections↗
PubMed1984

Umbilical cord pH and PCO2: effect of interval from delivery to determination.

Determinations of umbilical blood pH and PCO2 can be useful for correlating intrapartum fetal heart rate patterns, intrapartum samples of scalp blood, and Apgar scores, for the retrospective evaluation of the management of a particular labor. Occasionally, such data can indicate and clarify needed resuscitative measures and intensive neonatal observation. Cumbersome techniques have been described for the handling of specimens of cord blood to ensure an accurate determination. This study was performed to determine the effect on cord blood pH and PCO2 of room temperature and time from delivery. One hundred five cord venous or arterial determinations had a linear pH decrease versus time at room temperature. The regression slope was -3.66 X 10(-4) per minute with a standard deviation of 1.37 X 10(-2). The PCO2 showed only a slight increase with time at room temperature, although the scatter was high, with a standard deviation of 3.8 torr. The conclusion is that samples of cord blood drawn for determination of pH and PCO2 can be kept at room temperature in plastic syringes for up to 30 minutes without significant alteration in these values, i.e., pH decrease no greater than 0.04 unit (p less than 0.05).

Apgar Score↗
PubMed1984

Case report of ECT during high-risk pregnancy.

The authors present the case of a depressed woman given ECT during pregnancy and list administrative and monitoring techniques for protection of both fetus and mother when ECT is administered during pregnancy.

Adult↗
PubMed1984

Amylase and isoamylase activities in serum of pregnant women.

The data previously reported for serum amylase activity in the blood of pregnant women are conflicting with respect to normal values and the relationship of activity to duration of pregnancy. By use of a DuPont Automatic Clinical Analyzer, amylase activity in serum from the blood of 413 asymptomatic healthy women who were six to 40 weeks pregnant was determined. Samples with amylase activity greater than 100 IU/L were tested for pancreatic and salivary isoenzymes. In every case except one, the isoenzyme levels were normal. In the blood of all women, except this one, the serum amylase activity was less than 150 IU/L and mean serum amylase activity did not correlate with gestational duration. Amylase activities at all gestational ages did not differ from the activity in serum obtained from the blood of women six weeks post partum. The authors conclude that 1) serum amylase levels may be as high as 150 IU/L in the blood of normal pregnant women; 2) serum amylase activities vary widely among pregnant women, but not in a manner related to the stage of gestation; and 3) pregnancy does not cause elevation of serum amylase isoenzyme activity.

Amylases↗
PubMed1984

Pregnancy and acute optic disc edema of juvenile-onset diabetes.

Acute optic disc edema is a recently recognized, relatively benign manifestation of juvenile-onset diabetes mellitus. Twenty-three cases have been reported in the ophthalmology literature, two occurring during pregnancy. The authors present an additional case recognized in a pregnant patient and review the literature. The disorder manifests physical findings similar to those of papilledema, proliferative retinopathy with optic disc edema, inflammatory papillitis, and ischemic optic neuropathy, but has a benign course that requires no treatment and is not adversely affected by pregnancy. It is important to recognize this syndrome because failure to make the correct diagnosis in pregnancy may lead to inappropriate treatment, including therapeutic abortion.

Acute Disease↗