Biomedical subjects
Publications and source records attributed to M P David.
Pregnant women with high estrogen levels were more sensitive to barbiturate-induced narcosis and hypothermia than nonpregnant and postmenopausal women. Within each group, there was a negative correlation between estrogen level and decreased sensitivity to barbiturates. It appears that estrogen alters resistance to barbiturates through its effect on the activity of dopamine receptors.
Pregnancy is a natural allograft and the mechanisms for its non-rejection are obscure. Depression of maternal cellular immunity was suggested as a possible explanation. Interleukin-2(IL-2) is a lymphokine release from OKT4+ lymphocyte. This factor has a crucial role in the proliferation and differentiation of T cell subsets, and controls functions associated with immune rejection mechanisms. We therefore examined the ability of lymphocytes from women in the 3 trimesters of pregnancy to produce IL-2 in culture. Mononuclear cells were cultured with PHA for 48 h. The IL-2-containing supernatant was added to and supported the proliferation of an IL-2 dependent T cell line. Proliferation of this line indicated the IL-2 content of the added supernatant. Using this assay, IL-2 production in all 3 trimesters of pregnancy was adequate and comparable to that of lymphocytes from non-pregnant women. These results suggest that the proposed defect in cellular immunity during pregnancy is not mediated by an inability of the lymphocytes to produce IL-2.
Explore the source record for details and available documents.
Standards for the relationship between BPD and gestational age are used for the assessment of fetal size. We measured the BPD in 310 women with exact gestational age in a cross-sectional study. Two types of BPD charts were constructed based on tolerance intervals: directly from measurements and after model fitting. We found that the tolerance intervals based on the model are smoother and narrower than those achieved by direct determinations. The fit, advantages, and prospects of the model are discussed.
Two hundred fifteen infertile women underwent hysterosalpingography (HSG) and laparoscopy. One hundred twenty-eight patients had bilaterally patent tubes on hysterosalpingography. Thirty-one percent of these women had pelvic adhesions diagnosed by laparoscopy. Eighty-seven women had either occluded tubes or suspected pelvic adhesions on hysterosalpingography. Thirty-nine percent of these women had patent tubes without any pelvic pathology on laparoscopy. Inaccurate diagnoses limit the value of hysterosalpingography in evaluation of tubal and peritubal pathology.
Histopathological findings in 226 post-menopausal bleeding women were reviewed retrospectively. Adenocarcinoma of the endometrium was diagnosed in 7% and hyperplastic endometrium in 15%. The incidence of malignancy showed a definite rise with advancing age, increasing amount and duration of bleeding, prolonged time interval between the menopause and onset of bleeding, and enlarged uterus. Adenocarcinoma of the endometrium was associated in 40% of the patients with either obesity, diabetes mellitus, or hypertension. The most frequent histopathological finding was atrophic endometrium (45%).
In a 5-year retrospective study, 543 singleton breech presented infants weighing more than 1000 g were reviewed in two obstetric departments. Department "A" actively conducted the labor with lower cesarean section rate (26%). Department "B" attempted a trial of labor with less invasive procedures and performed more cesarean sections (38% P less than 0.05 S). The management of labor, fetal and maternal outcome were compared between the two departments. Both vaginal and abdominal routes of delivery in fetuses weighing more than 1500 g resulted in the same fetal and maternal outcome. For fetuses weighing 1000-1500 g cesarean section is probably the recommended delivery route.
In pregnancies complicated by diabetes mellitus fetal heart rate (FHR) monitoring is widely utilized to detect early fetal compromise. Never, however, was the fetal heart rate monitored during a maternal hypoglycemic coma. Such a case is here presented.
Core and peripheral body temperatures were recorded in 24 parturients in labor with epidural analgesia and in 9 control parturients without analgesia. Shivering occurred in 11 (46%) of the women with epidural analgesia and in one parturient without analgesia. Twelve patients (50%) showed increase in leg and chest temperatures after injection of bupivacaine 0.35% into the epidural space. Lumbar epidural analgesia may produce shivering and temporary temperature changes in the periphery. Core temperature is not significantly altered.
Ninety-four singleton vaginal breech deliveries conducted under extradural analgesia were compared with 277 singleton vaginal breech deliveries conducted without extradural analgesia. Mean duration of the first stage of labour was similar in both groups. Mean duration of the second stage of labour was prolonged and mean 1-min Apgar scores were less in fetuses weighing more than 2500 g in the extradural group. Mean 5-min Apgar scores, perinatal morbidity and maternal complications were similar in both groups.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Fifty-one women with only minimal and moderate intrauterine adhesions (Asherman's syndrome) underwent dilatation of the cervix, lysis of adhesions and insertion of intrauterine contraceptive devices (IUDs). A pregnancy rate of 90% was achieved. In 85% of the pregnancies a viable infant was delivered, and 15% terminated in abortions. No complications of pregnancy or of the third stage of labor were noted. The most common procedure preceding the appearance of intrauterine adhesions was curettage for spontaneous abortion and less frequently for missed and induced abortions. It seems that in mild and moderate Asherman's syndrome, lysis of adhesions and IUD insertion without estrogen administration yield satisfactory results.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
A case of tubal pregnancy demonstrated by sonography is presented. In addition to the true ectopic gestational sac, an intra-uterine structure closely resembling a gestational sac was detected simultaneously. Such a finding of a pseudogestational sac in the uterine cavity may mislead to the diagnosis of an intra-uterine gestation. Thus, this sonographic finding is not sufficient to exclude the diagnosis of ectopic pregnancy. Clinicians should be aware of the possible finding of a pseudogestational sac in cases of ectopic pregnancy and the pathophysiological basis of this phenomenon is discussed.
Explore the source record for details and available documents.