Search PubMed⌕ Search

Biomedical subjects

M L Socol

Publications and source records attributed to M L Socol.

71 records · Page 4Linked to original sources
PubMed1984

Placenta previa: aggressive expectant management.

We report the outcomes of 95 expectantly managed cases of placenta previa; all were diagnosed after 21 weeks' gestation. Patients at risk for preterm delivery because of hemorrhage or preterm labor received aggressive care, including multiple transfusions, volume expansion and tocolytic therapy, and amniotic fluid surfactant determinations, to achieve the goal of delivery at 37 weeks' gestation with mature fetal lung function. We present guidelines for outpatient management and double setup examination prior to delivery. The role of ultrasound in diagnosis (three asymptomatic cases; 13 cases with preterm labor) and serial placental localization to determine the timing, route, and place of delivery is presented. Eighty-six percent of 19 infants born weighing less than 2500 gm were managed expectantly. Hemorrhage was the determinant in delivery timing in 50 cases. All four deaths were neonatal with birth weights less than 2200 gm. This is the lowest perinatal mortality rate (4.2%) published to date. Use of this aggressive approach is particularly suitable for patients cared for in a teritary center.

Adolescent↗
PubMed1984

Intrauterine growth of chronically instrumented rhesus monkey fetuses.

The effect of surgical and experimental manipulations on intrauterine growth of the fetus was investigated in 61 rhesus monkey fetuses in which chronic preparations were attempted. The surgical procedure consisted of hysterotomy and insertion of vascular catheters and included unilateral ligation of the fetal carotid artery. The mother was kept in a restraining chair after the operation for the duration of the preparation (0 to 39 days). Thirty-four fetuses who died within 48 hours after operation served as the control group for the growth parameters. The remaining fetuses that survived 7 days or more after the operation were included in the experimental group. Body weight, crown-rump length, crown-heel length, and foot length of the fetus and placental weight were measured at the termination of the preparation. There were significant linear correlations between all parameters and gestational age. Comparison between the control and experimental groups revealed that none of the parameters from the experimental group differed significantly from those of the control group. No relationships were found between the duration of the preparation and any of the parameters. Total brain weights from 19 fetuses exhibited a significant increase with gestational age and these values were within the normal range reported previously. There were no significant differences in weight between right and left cerebral hemispheres. No evidence of unequal blood flow to the cerebral hemispheres was found with the radioactive microsphere technique. The data suggest that the surgery performed on both the mother and the fetus and prolonged maternal restraint did not alter intrauterine fetal development.

Animals↗
PubMed1984

Control of preeclamptic hypertension by ketanserin, a new serotonin receptor antagonist.

We investigated the effect of peripheral serotonin receptor blockade on preeclamptic hypertension in 20 postpartum patients by the use of ketanserin, a serotonin receptor antagonist. In a study consisting of a double-blind crossover with placebo, parenteral ketanserin significantly reduced blood pressure from 167/105 to 126/71 mm Hg compared to a decline from 157/98 to 150/91 mm Hg for the placebo (p less than 0.001). All patients became hypertensive again following infusion, although no abrupt rebound in pressure occurred. Side effects were minimal. The results demonstrate that preeclamptic hypertension can be controlled by ketanserin and suggest that serotonin may have a role in the modulation of preeclampsia.

Adult↗
PubMed1984

Diminished growth in fetuses born preterm after spontaneous labor or rupture of membranes.

We examined biparietal diameter, abdominal circumference, and birth weight in 148 preterm infants to assess fetal growth. A statistically significant proportion of preterm fetuses had biparietal diameter and abdominal circumference values below the fiftieth and tenth percentile levels as compared with that expected in normal fetuses. Similarly, birth weight of infants in the study fell significantly below the fiftieth and tenth percentiles relative to Brenner's curve. We conclude that diminished fetal growth is associated with early delivery secondary to preterm labor or preterm premature rupture of membranes or both. Additionally, since biparietal diameters in preterm fetuses are smaller than those of normal fetuses the prediction of gestational age by cephalometry should be advanced by 7 to 10 days.

Birth Weight↗
PubMed1984

The tap test: a rapid indicator of fetal pulmonary maturity.

We present here a new means to assess fetal pulmonary maturity called the tap test. It is rapid, inexpensive, and requires only 1 ml of amniotic fluid. The tap test was compared to the phospholipid profile in 88 fetuses, 70 of whom were delivered before term. All fetuses were born within 72 hours after the amniotic fluid specimen was obtained. The test results were correlated to the absence or presence of the neonatal respiratory distress syndrome. When the tap test was evaluated at 2, 5, and 10 minutes, the predictive values for a mature test result were 100%, 98%, and 98%; the predictive values for an immature test result were 43%, 52%, and 58%, respectively. For the phospholipid profile the predictive values for a mature and an immature test result were 98% and 37%. These findings indicate that the ability of the tap test to predict fetal pulmonary maturity is comparable, if not superior, to that of the phospholipid profile.

Amniotic Fluid↗
PubMed1984

Urinary estriols in diabetic pregnancy: a reappraisal.

The clinical usefulness of serial urinary estriols was tested in 138 insulin-dependent diabetic pregnant women. No action was taken on an estriol drop if fetal well-being was demonstrated by a reactive nonstress test and/or negative contraction stress test within 24 hours. Of 3085 estriol values, a greater than or equal to 40% estriol drop, confirmed by a greater than or equal to 40% decrease in the estriol-creatine ratio, was observed in 21 tests. In only two of these tests, was fetal distress indicated by a nonstress test or contraction stress test. A significant linear correlation was demonstrated between the mean level of estriol excretion and birth weight, placental weight, and fetal abdominal circumference measured by ultrasound. Chronically low estriol excretion (less than 12 mg per 24 hours at greater than 36 weeks' gestation) related to smaller placentas but not to fetal jeopardy.

Apgar Score↗
PubMed1984

Diminished biparietal diameter and abdominal circumference growth in twins.

Forty-three women with uncomplicated twin pregnancies and reliable menstrual dates had serial ultrasonic measurements of the fetal biparietal diameter (BPD) and abdominal circumference. The 25th, 50th, and 75th fetal BPD and abdominal circumference growth percentiles were generated from this normal twin population and compared with those for singletons. A slowing of both BPD and abdominal circumference growth in twins was noted in the third trimester. However, newborn anthropometric data were collected that suggest that the head circumference of twins is comparable to that of singletons. This discrepancy between ultrasonic BPD and neonatal head circumference in predicting head size may possibly be explained by dolichocephaly attributed to uterine crowding. For the antenatal assessment of growth in twins the authors recommend the use of BPD and abdominal circumference charts derived specifically from such uncomplicated twin pregnancies. When the BPD growth is abnormal, the head circumference and abdominal circumference should be measured to assess whether or not fetal growth is normal.

Abdomen↗
PubMed1982

Maternal smoking causes fetal hypoxia: experimental evidence.

Cigarette smoking during pregnancy has been related to poor perinatal outcome. To investigate the changes in maternal and fetal arterial blood gases associated with smoking, five chronically catheterized pregnant rhesus monkeys were exposed to standard cigarette smoking (N = 5) and nicotine-free herbal cigarette smoke (N = 3). The only consistently reproducible and significant finding was a drop in fetal PO2. The timing of the decline in PO2 and the similar responses to standard and nicotine-free cigarette smoke make carboxyhemoglobin the most likely causative factor.

Animals↗
PubMed1981

A cyclic variation in thyroid-stimulating hormone in the fetal rhesus monkey.

Morning and evening simultaneous fetal and maternal plasma samples were analyzed for thyroid-stimulating hormone. An a.m.-p.m. variation in fetal concentrations was identified, whereas the majority of the maternal values (28 of 32) were below the sensitivity of the assay. The importance of this cyclic fetal activity is discussed.

Animals↗
PubMed1981

Normal fetal growth despite persistent amniotic fluid leakage after genetic amniocentesis.

Two women not only lost relatively large amounts of amniotic fluid immediately following genetic amniocentesis, but continued to lose fluid for the remainder of their pregnancies. Periodic ultrasonographic assessment confirmed normal fetal growth and presence of some amniotic fluid. Both women were delivered at term of normal offspring who showed no evidence of fetal deformations. Although amnionitis is a risk, cautious surveillance may permit continuation of pregnancies complicated by copious or persistent amniotic fluid leakage following genetic amniocentesis.

Amniocentesis↗
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↗
PubMed1978

Plasma cortisol in the chronic rhesus monkey preparation (Macaca mulatta).

The short- and long-term effects of surgical procedures and chair restraint on total plasma cortisol were assessed in the chronic rhesus monkey preparation. Three nonpregnant and six pregnant animals were sampled daily, morning and evening. Fetal plasma specimens were obtained simultaneously from the pregnant animals. In the nonpregnant rhesus monkey, a circadian rhythm is present the day following venous catheterization and chair restraint, with individual values similar to those in trained, unanesthetized animals. In the pregnant animals, a postoperative rise in cortisol is followed by a gradual decline to a plateau and a return of circadian rhythm. No consistent daily fluctuations are seen in fetal cortisol, and although correlated with maternal cortisol, the exact relationship is uncertain. The data indicate that operation, as expected, is stressful but acclimation to the chair occurs.

Animals↗