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Biomedical subjects

R T Burkman

Publications and source records attributed to R T Burkman.

At least 73 records · Page 4Linked to original sources
PubMed1984

Use of osmotic dilators to facilitate induced midtrimester abortion: clinical evaluations.

A number of studies evaluating an osmotic cervical dilator consisting of polyvinyl foam saturated with magnesium sulphate in women undergoing midtrimester abortion with intra-amniotic hyperosmolar urea plus prostaglandin F2a were completed. Comparisons with women receiving no pre-treatment with a laminaria tent or with one laminaria indicate that their use appears to shorten injection-abortion intervals, particularly in parous women, and reduce risk of endometritis and cervical laceration compared to women not receiving any type of device. The data suggests that two osmotic dilators may be more effective than one. Also, magnesium toxicity does not appear to be a substantial risk with their use.

Abortion, Induced↗
PubMed1984

Morbidity risk among young adolescents undergoing elective abortion.

A cohort study comparing risks of morbidity at the time of elective abortion between 399 young adolescents aged 17 years or less matched to 399 women aged 20 to 29 years was completed. The study matched for duration of gestation, types of procedure, parity, race, month of procedure, and insurance status. Results indicated a relative risk of post-abortal endometritis for adolescents compared to older women of 2.5 (95% C.L. 1.48, 3.85). The reasons for this difference are unclear.

Abortion, Induced↗
PubMed1983

Type of intrauterine device and the risk of pelvic inflammatory disease.

To study the association of pelvic inflammatory disease and various types of intrauterine devices (IUDs), data from the Women's Health Study were analyzed. The analysis included data from interviews of 622 women hospitalized with an initial episode of pelvic inflammatory disease and 2369 hospitalized control subjects reporting no history of pelvic inflammatory disease. Compared to the risk in women using no contraception, the relative risk of pelvic inflammatory disease in women currently using the Dalkon Shield was 8.3 (95% confidence limits 4.7 to 14.5). This represented a fivefold increase in risk compared to women currently using other types of IUDs. In this study, only 10% of women wearing an IUD were using the Dalkon Shield, yet they accounted for almost 20% of the excess risk of pelvic inflammatory disease occurring among all the IUD users. Most of the increased risk of pelvic inflammatory disease for women currently using other IUDs (excluding the Dalkon Shield) occurred in the first four months after insertion. These associations were not explained by differences between cases and controls in demographic variables, level of sexual activity, or medical history. The authors recommend that women still using a Dalkon Shield have it removed.

Female↗
PubMed1982

Cephalothin prophylaxis for midtrimester abortion.

A randomized prospective double-blind study was conducted to determine the efficacy of prophylactic antibiotics as compared with placebo in 198 women undergoing second-trimester intraamniotic injection abortions. Patients received either sodium cephalothin or placebo intravenously before the procedure and for up to 8 additional doses. In 11 patients postabortion endometritis developed; 2 had received the antibiotic and 9 had received a placebo (P less than .05). Prophylactic cephalothin decreased the incidence of endometritis in patients undergoing midtrimester injection abortion. An injection-abortion interval greater than 24 hours appears to identify patients at risk for the development of postabortion endometritis.

Abortion, Induced↗
PubMed1981

Association between intrauterine device and pelvic inflammatory disease.

The Women's Health Study, a concurrent case-control study at 16 hospitals in 9 cities across the United States, examined the relationship between use of an intrauterine contraceptive device (IUD) and pelvic inflammatory disease (PID) severe enough to require hospitalization. After final classification, 1447 patients were eligible as PID subjects and 3453 patients were eligible as controls. For all current IUD users, the estimated relative risk of hospitalization with the diagnosis of PID was 1.6. However, the relative risk was about twofold when only individuals experiencing their first episode of the disorder were considered. The study also demonstrated an increased association for women aged 25 years or less and for nonblack women. Recent insertion or reinsertion of an IUD was associated with increased risk for PID, but total duration of use was not. Furthermore, the effect of IUD use on the development of PID persisted for several months after the IUD had been removed. The study also confirmed previous findings that the type of device does not markedly influence risk, and that the relative risk of PID is higher when IUD use is compared with use of other contraceptives or use of no contraceptives. Finally, the study suggests that users of nonpermanent forms of contraception other than the IUD have some form of protection against the development of PID.

Adolescent↗
PubMed1980

Intrauterine device use and the risk of pelvic inflammatory disease.

A number of studies have shown an association between use of the intrauterine device (IUD) and the development of pelvic inflammatory disease. In the nine studies reviewed, the estimated risk varied between 1.6 and 9.3. A number of interacting variables are operant, in addition to IUD use. Further, the use of nonpermanent forms of contraception other than the IUD may exert a protective effect against the development of PID.

Female↗
PubMed1980

The incidence of abdominal surgical procedures in a population undergoing abortion.

The incidence of abdominal surgical procedures was determined in 11,885 patients undergoing termination of pregnancy. Thirty-eight abdominal surgical procedures were completed, an incidence of 3.9 per 1,000 abortion cases. Seventy-two percent were completed for the diagnosis and management of coexistent genital pathologic conditions, with the remainder required for the management of abortion complications. These data provide patients an estimate of their chances of having to undergo abdominal surgical procedures, prior to their making a final decision to have a pregnancy terminated.

Abdomen↗
PubMed1980

An international program for the assessment of tubal anastomosis by microsurgical technique: a preliminary report.

This report outlines a microsurgical training program that has established 16 centers around the world for the reversal of sterilization by microsurgical technique and for the evaluation of such procedures. An obstetrician-gynecologist was selected from each of several developing countries where an existing family planning program was responsible for a large number of sterilization procedures. Each course participant attended a 2-week course in microsurgical techniques for tubal anastomosis and then returned to his or her home country to establish a microsurgical center for sterilization reversal. Each of these centers has since been evaluated by the program director and is fully operational.

Education, Medical, Continuing↗
PubMed1979

Gestational trophoblastic disease within an elective abortion population.

Gestational trophoblastic disease, most commonly hydatidiform mole, is an unusual condition within the United States. The incidence of hydatidiform mole has been reported to vary from 1 in 1,200 to 1 in 2,000 pregnancies. This report described eight cases of hydatidiform mole among 4,829 patients presenting for elective first-trimester abortion. Factors which might account for the frequency of hydatidiform mole of 1 in 600 are discussed. Although the clinical course of patients with hydatidiform mole appears benign- gross examination of tissue obtained at suction curettage and the liberal use of histologic evaluation in questionable cases is required to make the diagnosis.

Abortion, Induced↗
PubMed1979

Placental histopathology of midtrimester termination.

Placentas spontaneously passed after second-trimester terminations of pregnancy using either hypertonic sodium chloride or hyperosmolar urea plus prostaglandin F2alpha (PGF2alpha) were examined to determine histologic characteristics. The placentas of hypertonic sodium chloride terminations demonstrated a type of "coagulation necrosis" that has been described previously, while placentas of pregnancies terminated by hyperosmolar urea plus PGF2alpha showed a similar pattern in about one half the cases but a histologic pattern of less severe damage in the remaining cases. The 2 groups showed no significant differences when characteristics such as injection-abortion interval or estimated hypertonicity of the fluid were examined.

Abortion, Induced↗
PubMed1979

Intravascular spill of hyperosmolar urea during induced midtrimester abortion.

Intravascular spill of hypertonic sodium chloride and the resultant serious and occasionally fatal consquences have been reported in association with induced midtrimester abortion. This report details 3 cases of intravascular spill of hyperosmolar urea. Although urea may pose less concern, because of its ability to readily cross cell membranes and its action as an osmotic diuretic, inadvertent intravascular spill can produce symptoms that include nausea, headache, sensations of warmth, and intense uterine cramping. In addition, abnormal blood pigments may occasionally be noted in the urine. Treatment includes intravenous hydration, careful monitoring of fluid/electrolyte balance and renal function, and avoiding the use of oxytocic agents.

Abortion, Induced↗
PubMed1978

Hyperosmolar urea for elective midtrimester abortion. Experience in 1,913 cases.

Intra-amniotic hyperosmolar urea (59.7 per cent) augmented by intravenous oxytocin (332 millimicron per minute), prostaglandin F2alpha (20 mg.), prostaglandin F2alpha (10 mg.), or prostaglandin F2alpha (5 mg.) was utilized for 1,913 patients requesting elective midtrimester abortion. Injection-abortion intervals ranging from 13.70 to 21.49 hours were achieved with failure rates of 0.7 to 6.7 per cent. Despite frequent pre-existing medical conditions, the complication rate compared favorably with those of other methods for terminating midtrimester pregnancy such as saline amnioinfusion or dilatation and evacuation.

Abortifacient Agents↗
PubMed1978

Bacteriologic culture results obtained before and after elective midtrimester urea abortion.

Twenty patients undergoing elective midtrimester abortion by urea amnioinfusion had bacteriologic culture data obtained before and after the procedure. Despite the presence of pathogens in the vagina and cervix prior to the procedure, only 20% of patients exhibited endometrial growth following abortion. Factors that seem to favor such endometrial growth include increased injection-abortion intervals and the requirement for curettage to manage incomplete abortion.

Abortion, Induced↗
PubMed1977

Intra-amniotic urea and prostaglandin F2alpha for midtrimester abortion: clinical and laboratory evaluation.

The clinical management of the elective midtrimester abortion continues to be unsatisfactory as judged by either national mortality or morbidity rates. This report documents the results of a randomized series of 19 midtrimester abortions induced by either intra-amniotic hyperosmolar urea and 5 mg. of prostaglandin F2alpha (PGF2alpha) or intra-amniotic hyperosmolar urea alone. Pertinent clinical characteristics and biochemical determinations were compared between these two groups. A series of 150 patients were then treated with urea and 5 mg. of PGF2alpha. The clinical results of this series of patients are presented and compared with a previous group who had urea and 10 mg. of PGF2alpha. These studies demonstrate that 5 mg. of PGF2alpha with 80 Gm. of urea achieves injection-abortion intervals that are less than 24 hours.

Abortion, Induced↗