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Biomedical subjects

N A Beischer

Publications and source records attributed to N A Beischer.

At least 91 records · Page 5Linked to original sources
PubMed1982

Antenatal pregnancy complications and fetal growth retardation.

This study reports the associations between antenatal complications, subnormal urinary oestriol excretion and perinatal death in 500 pregnancies when the baby weighed less than the 10th centile for gestational age at birth, compared with those in a series of 500 pregnancies when the baby was of a normal weight for gestation. The overall incidence of antenatal complications was not higher in those pregnancies in which the fetus was growth retarded, although early onset pre-eclampsia, threatened abortion, diabetes mellitus and accidental haemorrhage were commoner (P less than 0.05). The incidence of subnormal urinary oestriol excretion was significantly higher in pregnancies in which the fetus was growth retarded, both when other antenatal complications were present (54.7% in the study group, 18.4% in the control group P less than 0.001) and in uncomplicated pregnancies (37.7% and 13.3%, respectively, P less than 0.001). Subnormal oestriol excretion identified 20 of the 26 perinatal deaths in the growth retardation group and 4 of the 6 perinatal deaths in the control group. Perinatal mortality was 10 times higher in growth retarded infants than in infants of appropriate size for gestation when pregnancy was not complicated antenatally. This study confirms the need to identify the presence of fetal growth retardation antenatally to enable appropriate treatment and improvement in perinatal mortality. The presence of antenatal complications is not appropriate for identification, whilst subnormal urinary oestriol excretion was seen to have highly significant predictive value.

Estriol↗
PubMed1982

Nonimmunologic hydrops fetalis: a review of 61 cases.

Sixty-one cases of nonimmunologic hydrops fetalis were studied. The incidence of nonimmunologic hydrops fetalis, 1 in 3748 births, was unchanged in 2 decades. The mortality from nonimmunologic hydrops fetalis remained high (98%). Polyhydramnios (75%), anemia (45%), and preeclampsia (29%) were the commonest prenatal maternal complications, whereas postpartum hemorrhage or difficulty with placental delivery, or both, occurred in 64%. Ultrasound examination always was successful in detecting the hydropic state. Many presumed etiologic factors were noted, although in 38% no possible cause was found. A major congenital anomaly was present in 41%. The obstetric and neonatal care of nonimmunologic hydrops fetalis must be improved. If nonimmunologic hydrops fetalis is diagnosed during the investigation of polyhydramnios, consideration should be given to early delivery in the interest of the fetus.

Edema↗
PubMed1981

Labour-onset pre-eclampsia.

In a consecutive series of 1,201 singleton pregnancies with pre-eclampsia, the onset occurred during labour in 290 (24.1%). There was no difference between the primiparous and parous patient in this respect (25.9% v 20.7%; P less than 0.10). The tendency for pre-eclampsia to develop during labour increased with advancing maturity of the pregnancy and seldom occurred before 38 weeks of gestation; this was again equally true of the primiparous and parous patient, as was the incidence of severe hypertension (diastolic pressure greater than 110mm Hg) (36.1% v 34.1%). The high incidences of severe hypertension (35.5%), proteinuria (41.7%), and eclampsia (2.1%), and the 1 maternal death testified to the severity of the disease process and the need for aggressive management. After delivery, the clinical signs tended to subside rapidly, but the early third stage of labour was a time of maternal risk, irrespective of whether ergometrine or Syntocinon was the oxytocic agent administered. Analysis of perinatal results showed that the risk to the fetus was minimal.

Adult↗
PubMed1981

Mortality and morbidity of fetal growth retardation.

This study reports the fetal outcome in 500 pregnancies when the baby weighed less than the 10th centile for gestational age at birth, compared with that in a series of 500 pregnancies where there was a normal weight for gestation. Fetal growth retardation (0-9th centile) had a significant positive association with perinatal mortality (5.2% versus 1.2%, P greater than 0.001) and low oestriol excretion (42.4% versus 15%, P greater than 0.001), but not with major fetal malformations or fetal asphyxia. In the study group, 20 of the 26 perinatal deaths were associated with subnormal oestriol excretion. When severe fetal growth retardation was considered (less than the 5th centile), the associations with perinatal mortality (19%) and subnormal oestriol excretion (63%) were stronger and a significant correlation with major malformations emerged (17%, P greater than 0.001). Detection of subnormal oestriol excretion allows identification and appropriate treatment of severe fetal growth retardation which should improve survival and neurological development in these infants. This study confirms that birth-weight below the 10th centile is an appropriate definition of fetal growth retardation in terms of perinatal mortality and morbidity.

Asphyxia Neonatorum↗
PubMed1980

Birth before arrival in hospital.

In a series of 35,466 booked patients, the incidence of birth before arrival in hospital (BBA) was one in 695 (0.14%). These labours were usually precipitate (71%), and 51% of them occurred in the patient's first or second pregnancy. Most BBAs were avoidable (65%) had the patients attempted to reach hospital at the onset of labour. A patient need not be concerned about the possibility of BBA if she presents for assessment when she believes that labour has begun.

Delivery, Obstetric↗
PubMed1980

Fetal growth retardation and pre-eclampsia.

In a series of 2434 patients with pre-eclampsia, the prevalence of fetal growth retardation was 8.7 per cent compared with 8.6 per cent in the total hospital population. The prevalence was increased in early-onset pre-eclampsia (18.2 per cent) (P less than 0.001) and reduced in late-onset pre-eclampsia (5.6 per cent) (P less than 0.001). In patients who later developed early-onset pre-eclampsia with fetal growth retardation, the prevalence of subnormal oestriol excretion was significantly increased (79.5 per cent) (P less than 0.001) as was the prevalence of hypoglycaemia (33.3 per cent) (P less than 0.001) suggesting that fetal growth retardation in these pregnancies preceded the clinical signs of pre-eclampsia. The prevalence of placental abruption (8.3 per cent) and the prevalence of perinatal deaths (28.7 per cent) were both significantly higher in pregnancies with early-onset pre-eclampsia and fetal growth retardation (P less than 0.001).

Abruptio Placentae↗
PubMed1980

Are there recognizable symptoms of abnormal glucose tolerance (hypoglycaemia and hyperglycaemia) in pregnancy.

The symptoms noted by 1,291 consecutive patients undergoing a glucose tolerance test during the third trimester of pregnancy were studied to determine whether their presence was attributable to obstetrically important hypoglycaemia or hyperglycaemia. Relevant symptoms were common and, apart from the more frequent occurrence of palpitations in patients with hyperglycaemia, did not have a significant relationship to maternal glucose tolerance patterns. Patients with hypoglycaemia weighed less, but did not evidence a reduced dietary intake, whereas those with hyperglycaemia smoked less. Symptoms classically associated with biochemical hypoglycaemia and hyperglycaemia were not reliable indicators for selection of patients with obstetrically significant hypoglycaemia or hyperglycaemia.

Female↗
PubMed1980

Placenta praevia without antepartum haemorrhage.

The incidence of placenta praevia praevia in a series in a series of 26,155 patients was 0.9%; in 81 of the 238 patients (34%) there was no antepartum haemorrhage. Placenta praevia was known to be present before delivery in only 12 of the latter group, the condition being diagnosed after vaginal delivery in 17 and at Caesarean section in 52. Approximately 40% of patients with placenta praevia who deliver vaginally have had no antepartum haemorrhage.

Cesarean Section↗
PubMed1980

Hysterectomy in obstetric practice.

A 9-year review (1971-1979) is presented of patients undergoing hysterectomy in the course of pregnancy. The incidence was 1 in 1,044 pregnancies (34 in 35,506). The principal indications were ruptured uterus (9), postpartum haemorrhage (8), placenta accreta (5) and neoplastic trophoblastic disease (4). In spite of the high incidence of hysterectomy in our community, the procedure was undertaken during pregnancy with great reluctance and usually only as a life-saving procedure.

Adult↗
PubMed1980

Maternal glucose tolerance during pregnancy with excessive size infants.

A study of maternal glucose tolerance conducted during 137 pregnancies in which the infant weighed 4540 g or more at birth revealed an increased incidence of hyperglycemia (20.4% P less than 0.01). Only when a birth weight of more than the 99th percentile was considered was a significant association with maternal hyperglycemia evident. However, 105 of the 137 patients (77%) had normal glucose tolerance, which indicated that hyperglycemia is not necessarily the cause of fetal overgrowth. When a woman delivers an infant with a birth weight of 4540 g or more, it cannot be assumed that she was a gestational diabetic.

Birth Weight↗
PubMed1979

Psychiatric disorders in obstetrics.

The incidence of serious psychiatric illness in 27,376 patients during pregnancy and the puerperium was one in 138 (0.7%). The puerperal-onset group comprised 64 of the 198 cases (32%) and, of these, 22% required admission to a psychiatric institution. Moreover, this group of patients had a recurrence rate of 45% in subsequent pregnancies. Clinical, ethnic and socioeconomic factors were analysed and compared with the same factors in a control group to seek significant associations that might indicate impending psychiatric disorders in obstetric patients.

Adult↗
PubMed1979

Fetal growth and placental function assessed by urinary estriol excretion before the onset of pre-eclampsia.

In a series of 1,316 patients with pre-eclampsia 744 had urinary estriol excretion measured before and 366 after the onset of clinical signs of the disease. Low estriol excretion had a highly significant association with fetal growth retardation and perinatal death both before and after the onset of clinical signs (p less than 0.001). As assessed by the incidences of low estriol excretion, fetal growth retardation, and perinatal wastage, pre-eclampsia of early onset (before 37 weeks) was a malignant disease in comparison with pre-eclampsia of late onset (after 37 weeks). Patients destined to develop early-onset pre-eclampsia had a high incidence of subnormal estriol excretion (25.4%; p less than 0.001). Although further deterioration of placental function occurred after the onset of clinical signs (41.3%; p less than 0.01), fetal growth and prognosis were already determined.

Estriol↗
PubMed1979

Carcinoma of the cervix, endometrium, and ovary: an 11-year review.

Over an 11-year period, 164 patients with genital tract carcinoma were managed at the Austin Hospital, Melbourne. For patients receiving primary treatment at the hospital, the five-year survival rates of patients with carcinoma of the cervix, endometrium, and ovary were 47.8%, 41.6% and 4.3% respectively. Improved results rest upon earlier diagnosis and alternative therapeutic measures, especially for carcinoma of the endometrium and ovary. Routine surveillance after initial therapy may detect asymptomatic metastatic disease when curative treatment is still possible.

Adult↗
PubMed1979

The effect of termination of pregnancy on maturity of subsequent pregnancy.

Therapeutic termination of pregnancy performed during the first trimester was associated with a statistically significant increase in the incidence of second trimester abortion and of premature labour in the next pregnancy. In a series of 520 patients who had previously been aborted 8.1% suffered a mid-trimester abortion in their next pregnancy and 8.6% had premature onset of labour (compared to 2.4% (P less than 0.001) and 4.4% (P less than 0.01) respectively in a control series). The incidence of incompetence of the cervix after termination of pregnancy was 4.4%.

Abortion, Spontaneous↗
PubMed1979

The recurrence rate and significance of low oestriol excretion in successive pregnancies.

A total of 440 women who had low oestriol excretion in a previous pregnancy was investigated by urinary oestriol assays in one or more subsequent pregnancies. The incidence of low oestriol excretion in the subsequent pregnancy was 29.1 per cent, or more than double that in the total obstetric population (13.4 per cent; p less than 0.001). Patients with persistently low oestriol excretion had a 40.8 per cent recurrence rate in subsequent pregnancies. When oestriol excretion was low in successive pregnancies it retained a significant association with increased incidences of stillbirths, neonatal deaths and fetal growth retardation. It was concluded that low oestriol excretion in a previous pregnancy is a definite indication to test fetoplacental function in subsequent pregnancies even when the clinical findings are normal.

Estriol↗