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Biomedical subjects

L Keith

Publications and source records attributed to L Keith.

At least 55 records · Page 3Linked to original sources

The Northwestern University Drug Dependence Program: the impact of intensive prenatal care on labor and delivery outcomes.

In 1976, the Department of Obstetrics and Gynecology at the Prentice Women's Hospital was invited to provide obstetric services to patients of the Drug Dependence Program administered by the Department of Psychiatry at Northwestern University Medical School. Patients were referred in the early stages of pregnancy if they agreed to participate in the Drug Dependence Program at the same time. Between April, 1976, and October, 1980, 58 women received prenatal, intrapartum and postpartum care. Forty-two of these patients had been abusers of opiates; 16 were polydrug abusers. The obstetric performance of these women was characterized by an absence of major problems. The mean weight of all infants delivered was 2,935 gm. There were no perinatal deaths. The individual weights, lengths, and head circumferences of the newborn infants were distributed in a relatively normal manner. Ninety percent of the infants were delivered at 37 weeks or more of gestation.

Adult↗

The vanishing twin.

In general, it has not been recognized that many twin or multiple gestations are lost in utero early in pregnancy. Until the advent of ultrasound, the ability to document early human fetal loss in multiple gestation was difficult. However, recent reports of serial ultrasound examinations of pregnant women have documented the "disappearance" of at least one of two gestational rings. Furthermore, the number of twins observed at delivery was significantly less than the number of twin conceptions originally identified by ultrasound during the first trimester. These observations led to the concept of the "vanishing twin" [8,10,13,15,17,20,22,35,41]. In order to obtain reference and personal data on this subject, we reviewed the literature and corresponded with members of the International Society for Twin Studies and obstetricians affiliated with Northwestern University Medical School, Chicago, Illinois. The nine studies that have documented this phenomenon cite "disappearance" rates ranging from 0% to 78%, depending on patient population and timing of ultrasonography [8,10,13,15,17,20,22,35,41]. Several explanations are offered: physiological mechanisms of "disappearance" (resorption or formation of a blighted ovum or fetus papyraceus), artifactual error, incomplete scanning technique, and poor quality ultrasound equipment. The only complication thus far associated with "disappearance" of a fetus is slight vaginal bleeding.

Abortion, Spontaneous↗

The Northwestern University multihospital twin study. I. A description of 588 twin pregnancies and associated pregnancy loss, 1971 to 1975.

Five hundred eighty-eight women who were delivered of twins at 13 hospitals affiliated with the Northwestern University Medical School or its outreach institutions between 1971 and 1975 were studied. Eighty-six of the infants did not survive the pregnancy, delivery, or the first week post partum. Maternal demographic and obstetric characteristics are outlined. Infants are categorized by birth order and by birth weight. The mean weight (and standard deviation) of first twins was 2,388 gm (+/- 742 gm) and that of second twins was 2.314 gm (+/- 766 gm). The rate of pregnancy wastage was highest in mothers who were under 20 years of age, who were of low parity, and who were delivered prior to the physiologic maturation of the fetus. The crude mortality rate of twin 1 was 6.1/100 versus 8.5/100 for twin 2. The causes of death in all infants over 2,000 gm are listed. All pregnancy losses are categorized into unavoidable deaths (26.6%), probably not avoidable deaths (59.4%), and possibly avoidable deaths (13.9%).

Adolescent↗

The Northwestern University Multihospital Twin Study. II. Mortality of first versus second twins.

The results of a multihospital study involving a total of 588 twin pairs born in Chicago in 1970-1975 are reported, with special respect to differences in mortality between first and second twins by time as well as by cause of death. Mortality was higher in second than in first twins and most commonly occurred after delivery and was the result of immaturity and of respiratory distress syndrome.

Asphyxia Neonatorum↗

Experience with modern inert IUDs to date: a review and comments.

A review of data from various large-scale studies reveals as much variation between studies as between devices. Many factors clearly unrelated to the IUD design undoubtedly influence their efficacy and continued use. Thus, the conclusions of the 1968 FDA report on effectiveness and utility still appear valid at this time. They are: A. "The Committee finds adequate scientific data attesting to the effectiveness and utility of the intrauterine devices." B. "The intrauterine devices are highly effective in preventing pregnancy, although they are not quite as reliable as the hormonal contraceptives if the latter are taken according to instructions." C. "The rate of continuation of use is similar to that of the oral contraceptives and is far higher than that of traditional methods, at least among the socially and economically deprived."

Animals↗