Biomedical subjects
Publications and source records attributed to R C Goodlin.
Prostaglandin E2 vaginal suppositories were found to have associated maternal and fetal side effects no different than those in women undergoing spontaneous labor or labor induced with oxytocin.
A relatively atraumatic and simple technique for forceps rotation of the vertex is described for use when spontaneous rotation has failed to occur. The technique consists of applying the Laufe forceps as in a Scanzoni application to achieve maximum flexion of the vertex. The forceps blade is used only as an attachment for the finger rotation. No twisting of the forceps handle is required.
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An implanted maternal pacemaker was found to produce a stronger fetal scalp signal than did the fetal R wave, thus causing the fetal electronic intrapartum monitor to record maternal heart rate. The newborn infant was healthy and well.
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Munchausen syndrome is relatively common in pregnant women. Ten cases are presented. The symptoms may be anything that will achieve hospital admission. Our experience suggests that the patients be allowed to consider themselves ill so that escalation of their illness can be avoided.
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Static pressure is defined as the pressure existing at all points in the circulation when the heart is stopped and is a determinant of cardiac output and blood pressure. By using the proposed relationship that static pressure = cardiac output X "resistance to venous return," estimates were made of peripheral static pressure in pregnant women. Measurements of cardiac output and venous resistance were accomplished with indirect plethysmographic techniques. Approximately 65% of pregnant women with complications had elevated values for their estimated peripheral static pressure. It is proposed that estimation of peripheral static pressure has both diagnostic and therapeutic applications in women with complications of pregnancy.
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Myotonic dystrophy is a relatively common disorder. Since the clinical expression is highly variable, diagnosis is often made only after the birth of an infant with severe congenital myotonic dystrophy. Seven such cases are described. A history of obstetric complications was present in the six multiparous mothers. Neither the neonatal features nor the pregnancy complications are specific, but their combinations should suggest the diagnosis, which can be confirmed by neurologic evaluation of the infant's mother.
Two pregnant women at term had antenatal symptoms of impending preeclampsia (thrombocytopenia, liver dysfunction) and developed clinical signs of a leaking subcapsular liver hematoma in the immediate postpartum period. They were managed conservatively, with blood transfusions and ultrasonic computerized tomographic monitoring of the hematoma. Both did well, and their hospital stays were brief. These cases suggest that immediate celiotomy may not always be necessary for suspected liver hematoma associated with preeclampsia.
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Hyperplacentosis refers to the maternal manifestations of increased placental activity, such as elevated human chorionic gonadotropin, theca luteal cysts, preeclampsia, and/or pruritus. Six cases of apparent hyperplacentosis were diagnosed in the third trimester because of maternal complaints of pruritus. The association of maternal or fetal complications with hyperplacentosis is described.
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