Biomedical subjects
Publications and source records attributed to J D Keeping.
A survey of attendance for antenatal care at a public hospital in Brisbane was carried out. "Poor attenders" were more likely to be young, unmarried, grande multiparous, or aboriginal, and to live in a poorer area of the City. This group comprised 6.5% of the total population, but accounted for 14.6% of all low Apgar scores, 23% of all low birth weight babies, 23.1% of all stillbirths, and 18.2% of all neonatal deaths.
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The normal distribution of birth weight in a Queensland population has been surveyed. A method of analysis is presented which allows for the influence of a number of factors that affect birth weight.
Two cases of spontaneous rupture of the spleen are described. The first patient presented with fetal distress in the second stage of labour; the second with hypovolaemic shock. Both mothers and babies survived.
Publications relating to surgical procedures for sterilization have been reviewed, and the incidences of complications and subsequent pregnancies compared. Laparoscopic sterilization has the lowest incidence of complication, the morbidity rate being lower than that of laparotomy sterilization or hysterectomy, and the mortality rate lower than that of a single pregnancy or taking oral contraceptives for 1 year.
Two hundred and thirteen perinatal deaths occurred in a population of 10,539 deliveries over a 4-year period. The associated obstetric complications and circumstances were analysed. The majority of perinatal deaths occurred in fetuses in whom there was a serious malformation, or whose birth weight was less than 800 g. Of the 110 deaths which occurred in normal babies weighing 800 g or more, 54 were antepartum, 5 were intrapartum, and 51 were neonatal. The clinical features surrounding these deaths were classified, and their implications discussed.
The patterns of morbidity and management among clinic and private patients in a teaching hospital were compared by an audit of computerized case records. The clinic patients were more likely to have a poor obstetric history and antenatal complications, and the private patients were managed more actively. Perinatal mortality in the clinic patients was higher and was related to the higher frequency of low birth weight babies.
A prospective survey is described of 200 consecutive patients who had outpatient laparoscopic sterilizations by coagulation and division of the Fallopian tubes. The procedures were acceptable to patients, free of morbidity or complications and made minimal demands on the existing hospital services.
Lecithin has been measured in amniotic fluid, pharyngeal aspirate, fetal and maternal plasma and fetal membranes from the same pregnancy. In the amniotic fluid from a term pregnancy 79 per cent of the lecithin is found in the reconstituted precipitate of centrifuged fluid. It is suggested that the lecithin of amniotic fluid may originate from sources other than fetal lung and that lecithin concentration is therefore a measure of overall fetal maturity.