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Biomedical subjects

M L Pernoll

Publications and source records attributed to M L Pernoll.

At least 37 records · Page 2Linked to original sources

Septic pelvic thrombophlebitis: an update.

Septic pelvic thrombophlebitis is the result of serious pelvic infection usually following obstetric or gynecologic procedures. The management of this condition is of historical interest to the department of obstetrics and gynecology at Tulane, and therefore a retrospective case evaluation and a prospective surveillance were undertaken. This study indicates that septic pelvic thrombophlebitis is seen very rarely today. Possible reasons for the decline in the incidence of this problem and a management plan are presented. Three cases are included.

Adult↗

Cesarean section while on cardiac bypass: report of a case.

The first case of cesarean section while the patient was on cardiac bypass with favorable outcome for both mother and perinate is reported. the surgery was necessary because of a thrombosed mitral valve prosthesis. The major management dilemmas posed by this unusual case stimulated a survey of the literature concerning maternal and perinatal outcome in pregnancies complicated by cardiac disease, cardiac surgery, prosthetic valves, and/or anticoagulation.

Adolescent↗

Uterine oxygen uptake in the pregnant Pygmy goat.

The diffusion equilibrium method was used to measure uterine blood flow (Qut) and oxygen consumption (VutO2) of 7 Pygmy goats in the last third of pregnancy. VutO2 was 9.3 +/- 1.3 (mean +/- SEM) ml.min-1.kg-1 weight of the uterus and its contents: the placenta, fetus and fetal membranes. This O2 requirement was provided by a high blood flow (349 +/- 48 ml.min-1.kg-1) and a narrow arteriovenous difference (2.4 +/- 0.1 vol%) across the uterus. Maternal arterial O2 content (CaO2) was varied by incurring chronic anemia in 3 animals. CaO2 over the range 6.5 - 12.8 vol% did not affect uterine blood flow or the arteriovenous oxygen content difference across the uterus. Weight specific (ml.min-1.kg-1) VutO2 did not differ in animals whose total uterine weights varied over a wide range and uterine vein oxygen tension and content did not fall prior to delivery. We conclude that the absolute uterine blood flow varies over a wide range to meet the requirements of the uterine contents.

Animals↗

The fragmented intrauterine device: an unusual complication of a Lippes loop.

Fragmentation on removal of an effective and asymptomatic Lippes Loop is reported. The etiology of this event is hypothesized and the patient's managment is discussed. It is likely that fragmentation occurred as a result of material fatigue secondary to movement about the fixed, embedded tip. Surgical removal was effected.

Adult↗

Rational management of perinatal hydrocephalus.

Hydrocephalus of prenatal origin, which may be hereditary, is likely to be discovered more frequently and earlier in gestation with ultrasonic diagnosis. It is suggested that each case be analyzed according to a protocol which includes a full obstetric evaluation, complete genetic pedigree, determination of familial cranial size, and complete neuropathologic study. Destruction of the aqueductal area may deprive the investigator of much of the information needed for the thorough study of the case which is vital to counsel the parents concerning future pregnancies.

Delivery, Obstetric↗

The effect of blood, meconium, and temperature on the rapid surfactant test.

Amniotic fluid samples for physiologic maturity tests are frequently (15 to 20%) contaminated with blood and/or meconium. The effects of this contamination on the lecithin/sphingomyelin ratio is well known. However, less is known about the effect of blood and meconium on the rapid surfactant test. Additionally, because the RST may be performed in the office or at bedside, there is the possibility of temperature affecting the result. Therefore, the effects of blood, meconium, and temperature on the rapid surfactant test have been investigated. Contamination with blood or meconium may result in a false indication of fetal maturity. However, the test may still provide useful information concerning pulmonary status of the fetus, if the rapid surfactant test is intermediate or immature despite contamination. Temperature also affects the reliability of the rapid surfactant test. The test is found to be most reliable in the range of 20 to 30 C (with higher temperatures the bubbles dissipate more rapidly; with lower temperatures the foam is more stable).

Amniotic Fluid↗

A prospective evaluation of the lecithin/sphingomyelin ratio and the rapid surfactant test in relation to fetal pulmonary maturity.

Fetal lung maturity was correlated to the results of amniatic fluid analysis in 578 samples obtained over a 2 1/2 year interval. Lecithin/sphingomyelin (L/S) ratios obtained by planimetric and densitometric methods were compared to the rapid surfactant test (RST). Both the planimetric L/S ratio (P L/S) and the densitometric L/S ratio (D L/S) correlated positively in a highly significant fashion with the RST. Both RST and D L/S were reliable in predicting fetal lung maturity (99 to 100 per cent, respectively). The RST was the most reliable test for fetal lung immaturity (69 per cent). Therefore, this series indicates that the RST could be used as a primary method with the D L/S being useful as an additional indicator of fetal maturity when the RST was intermediate, or the sample contaminated with blood and/or meconium.

Amniotic Fluid↗

Oxygen consumption at rest and during exercise in pregnancy.

The oxygen consumption (Vo2) of 12 normal women was measured at monthly intervals during pregnancy and 2, 6 and 12 weeks and 6 months postpartum. At each study session measurements were made sitting at rest, during standard steady-state exercise on a bicycle ergometer, and for 10 minutes of recovery. A significant increase in exercise Vo2 was observed in late pregnancy when compared to paired postpartum values. The oxygen debt incurred by standard exercise was also greater in late pregnancy than 12-14 weeks postpartum.

Female↗

Ventilation during rest and exercise in pregnancy and postpartum.

The expiratory minute volume (Ve), respiratory frequency (f), tidal volume (VT), carbon dioxide production (Vco2), and end-tidal carbon dioxide concentration (FETCO2) and pressure (PETCO2) were measured at monthly intervals in 12 normal women during pregnancy and two, six and 12 weeks, and six months postpartum. At eacy study, measurements were made sitting at rest and during steady-state exercise at 306 kpm/min on a bicycle ergometer. During pregnancy, a significant increase in VE occurred, both at rest and during exercise, due to a significantly greater VT. Although VCO2 was significantly increased at rest throughout pregnancy and with exercise in late pregnancy, the respiratory exchange ratio (R) was not significantly altered during pregnancy. The FETCO2 was lower during pregnancy than postpartum, both at rest and during exercise. The ventilatory equivalent for oxygen (VE/VO2) was greater at rest near term and during exercise throughout pregnancy. However, resting physiologic dead space increased during pregnancy. Alveolar ventilation (VA) was calculated on the basis of three alternative assumptions: (1) that PETCO2 during exercise accurately reflects mean alveolar PCO2; (2) that the physiological dead space does not change during exercise; and (3) that mean alveolar PCO2 does not change from rest to exercise. Exercise VA, calculated on the basis of any of these three assumptions, is greater during pregnancy than postpartum.

Carbon Dioxide↗

Effects of freezing and thawing on certain properties of early gestation amniotic fluid.

The effects of repeated freezing and thawing. on certain properties of early gestation amniotic fluid were studied. Six anmiotic fluids from 15- to 17-week gestations were investigated. Total protein determinations revealed that there was no significant loss of total protein with rapid freezing and thawing up to 10 times in the space of a few days. Immunoelectrophoresis revealed that the antigenic properties of the amniotic fluid, as ascertained by counting the number of precipitin bands, were unaltered by the repeated freezing and thawing

Amniocentesis↗