Biomedical subjects

J C Hauth

Publications and source records attributed to J C Hauth.

154 records · Page 9Linked to original sources

PubMed1978

The bacterial pathogenesis of acute pelvic inflammatory disease.

To study the bacterial pathogenesis of acute pelvic inflammatory disease, peritoneal fluid was obtained by culdocentesis in 133 of 344 women with this disease. In 104 of the specimens bacteria were identified both in the gram-stained smear and culture. Neisseria gonorrhoeae was isolated from the lower genital tract in over half of these women, and there were 3 patterns of bacterial recovery from peritoneal fluid: N gonorrhoeae alone (22%), N gonorrhoeae and other organisms (32%), and nongonococcal organisms alone (46%). In women without cervical gonorrhea only nongonococcal organisms were identified from peritoneal fluid. In both groups of women a similar number of nongonococcal organisms were isolated. The results of this study supported those reported prior to availability of antimicrobials and suggest that N gonorrhoeae initiates most cases of pelvic inflammatory disease. A significant number of these women have superinfection with nongonococcal organisms which may preclude recovery of gonococci.

Acute Disease↗

PubMed1977

Gonorrhea screening in male consorts of women with pelvic infection.

Neisseria gonorrhoeae was isolated from 39% of male contacts of women with acute gonococcal pelvic inflammatory disease (PID); 22% of these men were asymptomatic. More than half of those women with gonococcal PID had at least one male sexual consort with gonorrhea. Neisseria gonorrhoeae was isolated from 15% of male contacts of women with nongonococcal PID; 30% were asymptomatic. Since a substantial number of male contacts of women with acute PID will have cultures positive for N gonorrhoeae and are asymptomatic, all male sexual consorts should be examined and have cultures grown for gonorrhea.

Disease Reservoirs↗

PubMed1977

Evaluation of tetracycline or penicillin and ampicillin for treatment of acute pelvic inflammatory disease.

To evaluate guidelines for outpatient treatment of acute pelvic inflammatory disease recommended by the Center for Disease Control we studied 197 afflicted women. The women were treated either with tetracycline or with procaine penicillin and ampicillin, and 92% were subsequently seen at least once to assess efficacy of clinical and microbiologic treatment. Neisseria gonorrhoeae was isolated from the lower genital tract in 68% of these women, and although they had a quicker symptomatic response than those with nongonococcal infection (P less than 0.01), the two regimens were equally effective in producing clinical cure. However, subsequent identification of a pelvic abscess was 10 times more common in women from whom N. gonorrhoeae was not isolated. Therapy for pelvic inflammatory disease must be empirical since it is impossible to distinguish clinically between gonococcal and nongonococcal infection, and our data indicate that both regimens recommended by the Center for Disease Control are effective.

Acute Disease↗

PubMed1977

Takayasu's syndrome in pregnancy.

Two cases of Takayasu's syndrome in pregnancy are presented. The obstetric courses of these women are compared with those of 7 others described in the literature. Symptoms of this rare condition may respond variably during pregnancy. Of the 9 women, 5 had worsening of their symptoms during gestation while 4 had milder symptoms than they had had prior to pregnancy. The best therapy is rest. Vaginal delivery is recommended and cesarean section should be reserved for obstetric indications.

Adult↗

PubMed1977

Early labor initiation with oral PGE2 after premature rupture of the membranes at term.

Two groups of healthy women at term, who were not in labor 3 hours after premature rupture of the membranes, were studied. In one group labor induction with oral prostaglandin E2 (PGE2) was begun 3 hours after rupture, and in the other group intravenous oxytocin induction was begun 12 hours after rupture. PGE2 was successful in initiating active labor in 88% of women treated. Of the women who were observed for 12 hours, one-half began labor spontaneously during that time. Women in whom labor was induced with PGE2 given 3 hours after rupture of the membranes had a shorter interval of rupture to delivery, a lower cesarean section rate, and shorter postpartum hospitalization. Although significant bradycardia did not occur in fetuses of those women given PGE2, 10% of infants whose mothers were receiving oxytocin were delivered by cesarean section for this reason. It is concluded that oral PGE2 is safe and effective for induction of labor in women with premature membrane rupture. The benefits, to both mother and fetus, of a shorter latent period are discussed.

Adult↗

PubMed1976

Oral prostaglandin E2 for labor induction in high-risk pregnancy.

Oral prostaglandin E2 (PGE2) was used alone or synergistically with intravenous oxytocin to induce labor in 84 women whose pregnancies were at high risk. A control group of 84 similar high-risk pregnancies where labor was induced with intravenous oxytocin alone was studied to compare the safety and efficacy of the two regimens. Oral PGE2 administration, combined with the synergistic effect of intravenous oxytocin, is safe for induction of labor in gravid women whose fetuses are at risk. Uterine polysystole, which is potentially dangerous, especially to the high-risk fetus, was not commonly encountered and only once was associated with transient fetal bradycardia. Uterine hypertonus was not encountered with PGE2; however, it did occur with oxytocin stimulation. Nausea and vomiting occurred in one third of the women treated with PGE2 but were well tolerated and required discontinuation of the drug in only one instance. There was no apparent advantage of using the combination PGE2 regimen in patients whose cervices were more favorable for induction of labor (Bishop score, 5 to 9). However, oral PGE2, used either alone or synergistically with oxytocin, appears twice as effective in inducing labor than was oxytocin alone in women in whom labor was considered to be "difficult to induce" (Bishop score, 0 to 4).

Administration, Oral↗

PubMed1976

Management of pregnancy-induced hypertension in the nullipara.

Three hundred and forty-six nulliparous women with pregnancy-induced hypertension prior to term were monitored in a high-risk pregnancy unit while awaiting fetal maturity. Management included ambulation as desired, regular hospital diet without salf restriction, blood pressure measured 4 times daily, weight and urine protein determined 3 times each week, creatinine clearance determined weekly, and serial sonography to monitor fetal growth. Sedation and antihypertensive agents were not prescribed. Delivery was delayed until term unless hypertension persisted or recurred following an initial salutary response. Factors other than hypertension that contributed to the decision to effect delivery were 1) rapid weight gain, 2) decreasing creatinine clearance, 3) appearance of significant proteinuria, 4) suspected fetal growth retardation, and 5) the development of severe headache or scotomata. With this method of management the perinatal mortality rate was 9/1000. Only 5 infants developed the respiratory distress syndrome and all survived. There were 26 women who left the unit against medical advice. Severe hypertension subsequently developed in 7 of these women and 4 of their fetuses were stillborn. The perinatal mortality rate among this group of patients was 154/1000. It is concluded that the nulliparous patient with pregnancy-induced hypertension prior to term can be safely managed by hospitalization and close observation as a viable alternative to prompt delivery.

Adolescent↗

PubMedDate not supplied

Vaginal misoprostol vs. concentrated oxytocin plus low-dose prostaglandin E2 for second trimester pregnancy termination.

OBJECTIVE: To examine the efficacy of vaginal misoprostol for mid-trimester pregnancy termination. METHODS: This randomized trial compared misoprostol, 200 microg per vaginum q 12 h to a protocol of concentrated oxytocin plus low-dose vaginal prostaglandin E2 suppositories (10 mg q 6 h). Success was defined as an induction-to-delivery interval < or =24 h. RESULTS: Interim analysis of the first 30 (15-misoprostol, 15-concentrated oxytocin) women demonstrated that the 2 groups were similar with regard to indication for delivery, gestational age, and demographic characteristics. Misoprostol was associated with a lower success rate (67 vs. 87%, P = .2), a longer induction-delivery interval (22 h vs. 18 h, P = .09), a higher rate of retained placenta requiring curettage (27 vs. 13%, P = .65), and a higher live birth rate (50 vs. 0%, P = .006). CONCLUSIONS: Compared to a regimen of concentrated oxytocin plus low-dose prostaglandin E2, misoprostol administered as vaginal tablets in a dose of 200 microg q 12 h is not satisfactory for mid-trimester pregnancy termination in an unselected population.

Abortion, Induced↗

PubMedDate not supplied

Umbilical cord serum levels of thromboxane B2 in term infants of women who participated in a placebo-controlled trial of low-dose aspirin.

OBJECTIVE: Our aim was to quantify thromboxane B2 (TXB2) in umbilical cord serum of term infants of nulliparous, low-risk women who were randomly assigned to either placebo or low-dose (60 mg) aspirin (ASA) on a daily basis from 24 weeks' gestation through delivery as part of a randomized clinical trial for prevention of preeclampsia. METHODS: Umbilical cord sera from 230 singleton, term infants whose mothers were involved in our low-dose ASA trial were assayed for TXB2, the stable metabolite of thromboxane A2, without knowledge of treatment or outcome data. The data were related to assigned treatment group, longitudinal pattern of maternal serum TXB2 levels, and other maternal and newborn characteristics. The data also were analyzed according to whether or not maternal serum levels of TXB2 at 29-31, 34-36, and delivery were reduced > or =50% compared to values prior to initiation of the trial. RESULTS: Umbilical cord TXB2 levels (ng/ml, mean +/- SE) were significantly lower at term in the ASA group (36.1 +/- 3.3, n = 111) than in the placebo group (56.6 +/- 5.7, n = 119; P = 0.002). Umbilical cord TXB2 levels were correlated to those in maternal serum at delivery in the ASA group (r = 0.3441; P = 0.0005) but not in the placebo group (r = 0.0626; P = 0.53). Regardless of assigned treatment group, infants whose mothers had a > or =50% longitudinal reduction in serum TXB2 had lower umbilical cord TXB2 levels (39.2 +/- 3.6, n = 114) than infants whose mothers had <50% reductions in TXB2 (54.6 +/- 5.9, n = 116; P = 0.027). Birthweights of these infants correlated inversely (r = 0.1678, P = 0.017) with maternal serum TXB2 at delivery but not to umbilical cord TXB2 levels; the best correlation between birthweight and maternal serum TXB2 was noted in pregnancies assigned to receive placebo (r = -0.2558, P = 0.009). CONCLUSIONS: Umbilical cord serum levels of TXB2 1) are reduced in instances of long-term maternal ingestion of ASA, 2) correlate well with maternal serum levels of TXB2 at delivery when there is evidence for consistent maternal use of ASA, but 3) do not correlate with maternal serum TXB2 levels when there is no evidence for frequent maternal ingestion of cyclooxygenase inhibitors. These data suggest that the capacity for platelet production of TXA2 in fetal and maternal compartments are regulated independently. Finally, there is an inverse relationship between maternal serum TXB2 levels at delivery and birthweight of newborn infants that is most evident among the pregnancies assigned to placebo and also among pregnancies in which there was little evidence to suggest a pattern of cyclooxygenase inhibitor use during pregnancy.

Adult↗

PubMedDate not supplied

Factors influencing plasma zinc levels in low-income pregnant women.

Plasma zinc (Zn) concentrations were measured in 4376 indigent women (86% African-American), at at mean (+/- SD) gestational age of 15 (+/- 7.8) wk to determine the relationship between various maternal characteristics and plasma Zn levels during pregnancy. Mean Plasma An levels were lower in African-American women than in Caucasian women, in multiparous women than in primiparous women, and in women with body weight > 69.9 kg than in those with body weight < or = 69.9 kg (p < or = 0.001 for each comparison). There were no significant differences related to maternal age, marital status, education, or smoking habit. Multiple regression analysis, including maternal prepregnancy weight, race, age, parity, smoking habit, education, and marital status indicated that race, parity, and pregnancy weight were significantly associated with maternal plasma Zn levels, adjusted for gestational age. Maternal race was the best predictor of plasma Zn concentrations among the population of pregnant women studied A significant proportion of variance in maternal plasma Zn levels. remained unexplained after taking into account various maternal characteristics. The reasons for lower plasma Zn levels in African-American women, compared to Caucasian women, during pregnancy are unknown.

Adolescent↗