Biomedical subjects

L E Edwards

Publications and source records attributed to L E Edwards.

At least 37 records · Page 2Linked to original sources

PubMed1979

Antepartum fetal testing. I. The oxytocin challenge test.

Two hundred seventy-eight high-risk patients were managed by a comprehensive assessment of the anatomic, biochemical, and functional environment of the fetoplacental unit utilizing predetermined guidelines. Decisions to terminate pregnancy were reserved for patients who demonstrated a positive OCT. Perinatal outcome in patients with positive OCT's was significantly worse than in patients who did not have a positive OCT. Patients with suspicious OCT's frequently had positive OCT's and were more likely to bear growth-retarded infants, whereas negative OCT's in general were associated with a favorable outcome. Correlation of estriol excretion with the OCT and perinatal outcome was inconsistent. There were a total of four prenatal deaths, all of which were considered unpreventable.

Congenital Abnormalities↗

PubMed1979

Antepartum fetal testing. II. The acceleration/constant ratio: a nonstress test.

For a period of one-half hour of undisturbed fetal monitoring, periodic changes of the FHR in response to spontaneous fetal movements (FM's) were recorded. FM's in patients who subsequently had positive OCT's were less likely to show accelerations (p = 0.001) and more likely to show variable decelerations (p = less than 0.001) and no change (p = less than 0.001) in the FHR when compared with patients who did not have a positive OCT. A ratio between the number of FM's associated with accelerations and the sum of FM's associated with no change and decelerations was defined as the acceleration/constant (A/C) ratio. The outcome in patients who exhibited reactive tests (i.e., A/C ratio greater than 1) was more favorable than the outcome in patients with nonreactive tests (i.e., A/C ratio less than or equal to 1). Patients with positive OCT's universally showed nonreactive tests, whereas patients with false positive OCT's were more likely to have reactive tests. Evidence is presented to suggest that the A/C ratio is more predictive of the intrauterine environment than the OCT.

Cesarean Section↗

PubMed1979

Prenatal care for pregnant adolescents in a public high school.

Two groups of pregnant adolescents enrolled in the St. Paul, Minnesota Maternal and Infant Care Project were involved in this study. A retrospective analysis of obstetrical summary sheets of delivered pregnant adolescents was conducted to demonstrate the relationship of the availiability of a comprehensive, interdisciplinary program of prenatal care in a regular public school setting to the achievement of early and continuous prenatal care and to the minimizing of obstetrical complications of the pregnant adolescents who were students in the school. A total sample of 36 students who received prenatal care in the school clinic (study group) from 1973 to 1976 was compared with a random sample of 36 adolescent patients (matched for race) who received care at a non-school clinic (comparison group). The data demonstrated that the study group initiated care earlier and had more total prenatal visits than did the comparison group. Also demonstrated were fewer obstetrical complications in the study group than in the comparison group. The comparison group had more low birth weight infants and more complicated deliveries than did the study group. Therefore, the results of this study support the initial objective and may have significance for educators and health personnel.

Adolescent↗

PubMed1979

A Simplified antepartum risk-scoring system.

The effectiveness of a simple antepartum risk-scoring system was evaluated in 2085 consecutive deliveries. Neonatal morbidity was observed in 42.1% of infants of mothers classified as high risk (score greater than or equal to 7) compared to 12.5% of infants of mothers classified as low risk (score less than 7). No neonatal deaths were observed in the low-risk group, compared with 34 in the high-risk group (P less than 0.001). Of all perinatal deaths, 88.6% occurred in the high-risk group. The perinatal mortality rates for low- and high-risk pregnancies were 7.2 and 63.3, respectively, per 1000 live births.

False Negative Reactions↗

PubMed1978

Gonorrhea in pregnancy.

Pregnancy complicated by gonorrhea was studied in 178 patients delivered of their infants over an eight-year period. There was an increased incidence of chorioamnionitis (p less than 0.05) and intrauterine growth retardation (p less than 0.05) in these patients when compared with matched controls. In 19 patients with positive gonorrheal cultures at delivery, there was a significant increase in the incidence of premature rupture of membranes (p less than 0.05), chorioamnionitis (p less than 0.05), and prematurity (p less than 0.05). Recurrence or persistence of positive cultures was found in 18 per cent of the patients with pregnancy gonorrhea. Two required hospitalization for intensive parenteral treatment when repeated attempts at outpatient management were unsuccessful.

Adolescent↗

PubMed1978

Pregnancy in the massively obese: course, outcome, and obesity prognosis of the infant.

The obstetric performance and pregnancy outcome in 208 massively obese patients who were delivered over an eight-year period were compared with those of nonobese control subjects. The incidence of obesity in their infants was also compared. No significant increase in the incidence of urinary tract infection, diabetes, breech presentation, cesarean section, forceps delivery, or maternal and infant morbidity was noted in the obese women. Significantly increased incidences of hypertensive disorders of pregnancy (p less than 0.01), gestational diabetes (p less than 0.01), inadequate weight gain (p less than 0.001), and wound or episiotomy infection (p less than 0.05) were observed in the study group. The mean birth weight of the infants of obese women was 209 grams greater than that of the control subjects. A significantly increased number of the obese patients were delivered of excessive-sized infants. Despite this, the incidence of obesity in infants of obese women was not significantly increased at birth or six months of age. By 12 months of age, however, these infants were significantly more obese than the control infants.

Adolescent↗

PubMed1977

Maternal intravenous ethanol in the prevention of respiratory distress syndrome.

The occurrence of respiratory distress syndrome (RDS) was studied in 68 premature neonates whose mothers were treated with at least one six-hour course of intravenous ethyl alcohol within 48 hours before delivery. At the gestational interval of 28 to 32 weeks, significant differences were observed in the incidence of RDS (p = less than 0.05), in severe RDS (p = less than 0.005), and in the mortality rate from RDS ( = less than 0.05), when compared to premature neonates not treated with alcohol and delivered during the same time interval. Several high-risk factors were found unevenly distributed between treated and control groups of patients, and their relevance to RDS was discussed. Premature rupture of membranes of more than 24 hours did not protect infants from RDS in the patients studied. Explanations for possible mechanisms of action are discussed.

Apgar Score↗

PubMed1977