Search PubMed⌕ Search

Biomedical subjects

S Arulkumaran

Publications and source records attributed to S Arulkumaran.

At least 181 records · Page 10Linked to original sources
PubMed1987

Chronic myeloid leukemia presenting as a gynecological emergency.

An unusual case of chronic myeloid leukemia presenting to the gynecological unit as a case of septic abortion is presented. Though history and clinical examination suggested the possibility of double pathology of septic abortion and chronic myeloid leukemia, histology of the products removed from the uterus showed it to be leukemic deposits. The diagnosis of leukemia was confirmed by marrow aspiration (trephine biopsy). Careful clinical examination and systematic investigation helped in diagnosing the pathology and to treat her appropriately.

Abortion, Septic↗
PubMed1987

Oxytocin titration to achieve preset active contraction area values does not improve the outcome of induced labour.

The value of controlling oxytocin titration in induction of labour by a present uterine activity, assessed as active contraction area, was examined in a randomized study in 60 nulliparae and 54 multiparae. Each parity group was divided into two groups according to the cervical score (less than or equal to 5 and greater than 5) and within those four groups the women were randomly allocated to oxytocin titration against a present frequency of 6-7 uterine contractions every 15 min, or to a preset uterine activity equivalent to the 75th centile for spontaneous labour. The length of labour was slightly, but not significantly, longer in the frequency group. The mode of delivery, Apgar scores at 1 and 5 min and cord artery blood pH values were similar with the two modes of oxytocin titration. The mean maximum dose rate of oxytocin infusion was not significantly different except in the nulliparous group with a poor cervical score. The given mean total dose of oxytocin was similar in the different groups when controlled for parity and cervical score. The results suggest that oxytocin titration to achieve uterine activity values equivalent to the 75th centile of those observed in spontaneous labour does not confer any advantage compared with the traditional practice of titrating the oxytocin infusion to achieve a preset frequency of uterine contractions.

Apgar Score↗
PubMed1987

Augmentation of labour--mode of delivery related to cervimetric progress.

This study was designed to investigate the possible benefits, in terms of obstetric and neonatal outcome, of a prolonged augmentation period with oxytocin in patients with dysfunctional first stage of labour. The majority of patients (65.5% of nulliparas and 83.8% of multiparas) responded with satisfactory progress within the first 4 hours of augmentation and the Caesarean section rate was low in this group (1.3%). In those with unsatisfactory progress during the first 4 hours of augmentation a further 4 hour period of augmentation resulted in vaginal delivery for 50.7% of nulliparas with primary dysfunctional labour and 33.3% of those with secondary arrest in labour. Corresponding figures for multiparas were 41.7% and 25.0%, respectively. The neonatal outcome was uniformly good. It is concluded that the management protocol presented for augmentation of labour seems to be a safe procedure and might reduce the rising Caesarean section rate for dystocia.

Female↗
PubMed1987

Effect of a beta-adrenoceptor antagonist, pindolol, on human uterine smooth muscle.

The effect of a beta-adrenoceptor antagonist, pindolol, on uterine smooth muscle in term pregnant women was studied in vitro and in vivo (in hypertensive women). In most preparations in vitro and in most patients in vivo, the drug induced an inhibitory effect on spontaneous uterine activity. The fetal heart rate was not affected by the drug. These actions of pindolol would make it an appropriate drug in the therapy of hypertension in pregnancy.

Adult↗
PubMed1986

Fetal acid-base balance in low-risk patients in labor.

The fetal acid-base balance from scalp blood in the early and late first stage of labor and from cord arterial blood was assessed in 120 low-risk patients only monitored electronically for 15 minutes at admission. The mean scalp blood pH values were 7.332 at a cervical dilatation of 5 cm and 7.335 at 10 cm cervical dilatation. A low pH value (less than 7.25) was found in 14 patients; five (4.2%) of them had fetal distress. Stethoscopic auscultation failed to identify these cases. Another nine patients had transient abnormal acid-base balance (a check value within 30 minutes was normal), and the fetal heart rate trace (obtained immediately after the sampling) showed no ominous changes in these cases. It is concluded that an abnormal fetal acid-base balance is not uncommon in a low-risk population in labor. However, a critical evaluation of the acid-base balance is necessary, since in most cases the abnormal acid-base balance is transient and of a respiratory, innocuous type without concomitant fetal distress.

Acid-Base Equilibrium↗
PubMed1986

Acute polyhydramnios and cord presentation--complication of chorioangioma of the placenta--a case report.

Chorioangioma of the placenta is an uncommon benign tumor of the placenta. Large tumors are rare and they often cause increased maternal morbidity and fetal morbidity and mortality. A patient with continuous abdominal pain at 29 weeks gestation was clinically diagnosed to have acute polyhydramnios. Multiple pregnancy was suspected because of a tense uterus much larger than the dates and three palpable "fetal poles". An ultrasound examination revealed the third pole to be a large chorioangioma. She went into premature labor and a cesarean section was performed because of a cord presentation. Both mother and infant had an uneventful recovery. The complications of chorioangioma is discussed.

Adult↗
PubMed1986

Catamenial pneumothorax.

Catamenial or menses related pneumothorax is a rare clinical manifestation of pulmonary endometriosis. We document a case where the clinical history was the key to diagnosis, and evidence of endometriosis elsewhere was scanty. Prolonged medical therapy was not preferred in our patient in view of her age and parity. Surgical pleural ablation was carried out to prevent further episodes of life threatening pneumothoraces. The investigations that may be useful in such a patient are discussed and the clinical profile of our patient is compared with those of the few cases reported in the literature.

Adult↗
PubMed1986

Atypical condylomas of the cervix uteri in Singapore women: a histopathological and immunohistochemical study.

Subclinical flat cervical warts are commonly recognized by means of colposcopy. These warty lesions frequently contain cellular atypia of a varying degree showing all the features of cervical intraepithelial neoplasia (CIN) together with the features of wart virus infection e.g. koilocytosis. Human papillomavirus (HPV) antigens and DNA have been found in these lesions which can be called atypical condylomas. The presence of such markers in lesions regarded as having neoplastic potential implicates HPV in cervical carcinogenesis. We investigated a group of Chinese women in Singapore to see whether this hitherto unstudied group showed HPV markers, in particular, HPV antigens by means of the peroxidase-antiperoxidase (PAP) staining technique. We found that histological warty change and HPV antigens were commoner in early compared with advanced CIN. These results, which are similar to previous studies, suggest that the aetiology of cervical carcinoma is probably no different in Singapore than in the West. They also suggest that HPV infection of the cervix is endemic in non-Western countries as well as in the West and may play a role in cervical carcinogenesis in diverse racial groups.

Antigens, Neoplasm↗
PubMed1986

Intrauterine responses to nipple stimulation in late pregnancy.

Characteristics of intrauterine activity in response to nipple stimulation were studied in 9 healthy pregnant subjects at term. All patients showed an increase in uterine activity varying from 10 to 730%. In 1 subject, marked uterine hypertonus was noted which resulted in profound fetal bradycardia. This response was transient, lasting 5.5 min, and fetal outcome unaffected. We believe that nipple stimulation is associated with a higher incidence of increased uterine activity in terms of frequency, intensity and basal tone, than has been previously recognized. This uterine hypertonus may affect the fetal heart rate adversely indicating the need to exercise caution when adopting this manoeuvre in late pregnancy, particularly when there is already evidence of fetal compromise.

Adult↗
PubMed1986

Medical treatment of placenta accreta with methotrexate.

Placenta accreta is a rare condition and is associated with considerable maternal morbidity and mortality. Though the surgical approach of hysterectomy is a definitive therapy, there are occasions when conservation of the uterus is desired by the patient. We report a case of placenta accreta successfully treated with intravenous methotrexate. After 2 weeks of treatment no signs of placenta could be visualized on ultrasound examination of the uterus. The patient was discharged after 15 days and has since been well. Such therapy may be useful in exceptional cases in institutions with adequate facilities for careful monitoring and management of the patient.

Adult↗