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Biomedical subjects

K A Keegan

Publications and source records attributed to K A Keegan.

26 records · Page 2Linked to original sources
PubMed1980

Antepartum fetal heart rate testing. IV. The nonstress test as a primary approach.

During a 1 year period from July 1, 1977, to June 30, 1978, 1,877 NST's were performed in 895 patients. Criterion for a reactive test was two accelerations associated with fetal movement in one of two 20 minute periods. Fetuses with nonreactive patterns were stimulated by abdominal wall manipulation. A total of 1,644 tests demonstrated reactive patterns and 229 tests were NR; 146 NR's were followed by CST's. During 75 CST's, the pattern became reactive and the test was terminated. Seventeen of 71 completed CST's were abnormal (24%). There were 634 patients delivered within 1 week of an NST-CST. Seventeen of 62 patients with NR tests underwent cesarean section for fetal distress as compared to 11 of 572 patients with reactive patterns.

Abdominal Muscles↗
PubMed1980

Antepartum fetal heart rate testing. V. The nonstress test--an outpatient approach.

A total of 567 tests were performed in a 1 year period on 399 patients in an outpatient clinic setting to test the feasibility of an office approach to antepartum heart rate testing. Of these tests, 510 were reactive and 57 were nonreactive (NR); 15 NR tests had associated spontaneous CST's; 39 NR tests and one reactive test with an equivocal spontaneous CST were repeated in 2 to 4 hours; 30 tests were reactive and nine tests remained NR. An oxytocin-induced CST was needed to clarify fetal status in only nine of 607 tests. With this approach, the NST may be quite appropriate for office use.

Female↗
PubMed1980

Double-blind comparison of intravenously injected butorphanol and meperidine in parturients.

One hundred women with moderate-to-very-severe prepartum pain participated in a double-blind study of intravenously injected butorphanol and meperidine that compared the analgesic properties, effect on the process of labor, condition of the newborn and the incidence of side effects associated with the two drugs. Cervical dilation, infant birth weight and Apgar scores were not significantly different between the test groups. The mean fetal heart rate for the butorphanol group was significantly faster than that of the meperidine group. Butorphanol provided significantly more analgesia than meperidine at 30 minutes and one hour after administration, based on pain intensity and pain relief scores. Some side effects, including sedation, dizziness, lightheadedness, nausea, vomiting and pain at the injection site, were reported for both drugs.

Adolescent↗
PubMed1980

Diagnosis of fetal death in utero by real-time ultrasound.

The efficacy of real-time ultrasound for the diagnosis of fetal death or hydatidiform mole was evaluated during a 1-year period. During this time, 116 patients were referred to the obstetric ultrasound service for the confirmation of clinical diagnoses. In 24 of 46 patients (52%) presenting in the first half of pregnancy, the referring diagnosis was confirmed. In 1 case of an early intrauterine pregnancy with a degenerating myoma, the ultrasound diagnosis of molar pregnancy was in error. In 48 of 70 patients (69%) referred after 20 weeks' gestation, the clinical diagnosis was confirmed. In no instance was either a false-positive or false-negative diagnosis made with real-time ultrasound in the last half of pregnancy. This method should prove to be the method of choice in diagnosing intrauterine fetal death.

Female↗
PubMed1979

Fetal breathing movements and the nonstress test in high-risk pregnancies.

Three hundred ninety-eight observations of fetal breathing movements (FBM) and the nonstress test (NST) were made in 223 patients. The presence of FBM was noted in a significantly higher proportion of tests with a reactive NST (88%) than a nonreactive NST (67%). Conversely, a significantly higher proportion of tests were reactive when FBM were present (82.6%) than when FBM were absent (49%). A significant relationship existed betweeen either test and the outcome of pregnancy as judged by the five minute Apgar score or the incidence of fetal distress in labor. Combining two normal tests did not improve the accuracy in predicting outcome; but the combination of both tests, when abnormal, produced a significant improvement in predicting fetuses likely to have an abnormal outcome. The combination of the normal with the abnormal test had a predictive accuracy similar to a single normal test in predicting a normal five-minute Apgar. This combination was associated with an incidence of fetal distress in labor intermediate between that seen with either the normal or abnormal test when alone. Neither a single test nor the combination of tests was helpful in identifying the small-for-gestational age (SGA) infants. These data indicate antepartum fetal evaluation may be improved when more than one biophysical variable is used.

Apgar Score↗