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Biomedical subjects

R A Kinch

Publications and source records attributed to R A Kinch.

47 records · Page 3Linked to original sources
PubMed1966

Continuous epidural analgesia for labour and delivery: review of 1000 cases.

In six years in London, Ontario, the use of continuous lumbar epidural analgesia in deliveries increased from 5% to over 50%. Its effect was assessed in 1000 consecutive cases, all vertex presentations. In established labour, epidural analgesia was started for pain relief and was maintained with intermittent injections until delivery; in 34% the duration exceeded four hours. Labour was not retarded, but there was an inadvertent selection of patients with slow and painful progress. Forceps delivery was used in 89%, mid-forceps in 11.8% and forceps rotation in 17.7%; 2.4% required Cesarean section. Fetal condition was excellent (Apgar rating of 7 or greater in 96.7%). Postpartum complications could not be directly related to the technique. Continuous epidural analgesia gives superior relief of pain but calls for experienced anesthetists and adjustments in obstetrical management and nursing care.

Anesthesia, Obstetrical↗
PubMedDate not supplied

The patient's choice in contraception.

The patient's choice of a contraceptive method is seemingly influenced by six factors: (a) her attitude toward contraception, (b) the physician's choice, (c) her assessment of risk, (d) her motivation and compliance for reliable contraception, (e) her previous experience with contraception and (f) her partner's influence. Recommendations are made for dealing with three groups of patients who present particular problems: (a) the patient who insists on the pill despite the contraindications for her emphasized by the physician; (b) the patient on the pill who is aging; and (c) the patient or couple who chooses tubal ligation at whatever age and regardless of the number of children she has borne.

Adult↗
PubMedDate not supplied

Evaluation of placental morphology and growth factor receptors in women receiving antiepileptic drugs: a pilot study.

A direct teratogenic effect of antiepileptic drugs (AEDs) on the fetus has been postulated. However, there may also be a primary effect of AEDs on placenta, with secondary consequences to the fetus. Thirteen carefully medically controlled epileptic women were followed prenatally and perinatally. Placentas from all were investigated morphologically and in two with electronmicroscopy. In nine patients, the placentas were studied with respect to insulin and insulin-like growth factor (IGF-I and IGF-II) receptor activity. In this pilot study of a group of carefully medically controlled epileptic women with low levels of AEDs, the results did not differ from normal controls. The possibility of adverse effects of higher concentrations of AEDs cannot be excluded, however.

Adult↗