Search PubMed⌕ Search

Biomedical subjects

W E Brenner

Publications and source records attributed to W E Brenner.

At least 19 recordsLinked to original sources
PubMed1978

Characteristics of patients with placenta previa and results of "expectant management".

To determine the differences between pregnancies complicated by placenta previa and those without placenta previa, the characteristics of 31,070 consecutive deliveries at one institution were analyzed. The philosophy of "expectant management" of the premature fetus and frequent use of cesarean section was utilized in the 185 patients with placenta previa. A higher proportion of these patients were multiparous, were older, had had previous abortions, and were carrying a male fetus or twins. The fetal and placental weights in these patients were similar to those in other patients throughout pregnancy. Rates of prematurity, antepartum and intrapartum fetal death, neonatal death, congenital abnormality, and low Apgar scores were higher among patients with placenta previa. Data were compiled in a manner that allows the obstetrician to: (1) evaluate the fetal weight and expected fetal growth; (2) estimate the probability that his patient will deliver prematurely and will deliver within the next one-, two-, or four-week interval; (3) determine the relative risks to the fetus prior to labor, during labor, and in the neonatal period at each stage of gestation.

Apgar Score↗
PubMed1978

The obfuscation of eclampsia by thrombotic thrombocytopenic purpura.

All case reports of TTP in pregnancy were reviewed. In some cases the primary diagnosis of TTP may have been inappropriate, with severe pre-eclampsia or eclampsia being the primary problem. Some cases of eclampsia and severe pre-eclampsia satisfy all the criteria for the diagnosis of TTP syndrome. However, the prognosis is much better and management of these patients is very different from the nonpregnant patient with the TTP syndrome. The use of the term TTP syndrome to describe these patients may be confusing. Two cases of eclampsia are presented where the diagnosis of TTP could have been made but would have been inappropriate.

Adolescent↗
PubMed1978

Catecholamines during therapeutic abortion induced with intra-amniotic prostaglandin F2alpha.

Serial plasma, amniotic fluid, and urine samples were analyzed for epinephrine (E) and norepinephrine (NE) in eight subjects during midtrimester abortion induced by intra-amniotic prostaglandin F2alpha (PGF2alpha). After PGF2alpha administration, plasma E increased and there was no change in plasma NE levels. Amniotic fluid levels of E and NE decreased initially. During the course of abortion the mean level of E in the amniotic fluid increased after fetal distress and decreased after fetal death, indicating that the midtrimester fetus of both E and NE increased following PGF2alpha. The observation that mean plasma levels and urinary excretion rate changes correlated better with the course of abortion and uterine contractility rather than with the time of PGF2alpha administration was consistent with the hypothesis that the catecholamine response may be due to the stress of labor rather than to the PGF2alpha per se.

Abortion, Therapeutic↗
PubMed1978

Arachidonic acid and other free fatty acid changes during abortion induced by prostaglandin F2alpha.

Serum free fatty acids (FFA's) were measured after intra-amniotic injection of prostaglandin F2alpha (PGF2alpha) for the induction of abortion in eight healthy women in the midtrimester of pregnancy. The total FFA levels increased in all cases during the period between PGF2alpha administration and abortion. This lipolysis most likely is secondary to the effect of the catecholamines as indicated by the temporal relationship between increased plasma and urine catecholamine and serum FFA levels. The percentage of arachidonic acid in the total amount of FFA's decreased after administration of PGF2alpha. This proportional decrease in arachidonic acid (p less than 0.05) may be due to selective utilization for the production of endogenous prostaglandins.

Abortion, Induced↗
PubMed1978

Clostridial sepsis after abortion with PGF2alpha and intracervical laminaria tents--a case report.

A case of clostridial endomyometritis and sepsis necessitating total abdominal hysterectomy which occurred 12 hours following abortion induced with intraamniotic administration of prostaglandin F2 alpha and laminaria tent insertion is discussed. Cultures from cervical, blood, and surgical specimens all yielded Clostridium perfringens. Intrauterine contamination with this microorganism most likely followed the insertion of laminaria tents through the cervical os, which was colonized with C. perfringens. Since C. perfringens may be present in the microflora of the lower female genital tract, great care must be taken to cleanse this area prior to intracervical laminaria tent insertion.

Abortion, Induced↗
PubMed1978

The thermogenic activity of exogenous E and F prostaglandins in humans.

A basic understanding of the physiologic effects of the prostaglandins on the human reproductive system has been one of the diverse scientific interests of Professor Axel Ingelman-Sundberg (19). Although the obvious clinical ultility of these ubiqitous compounds directed early attention to their therapeutic aspects, more recently there has been renewed interest in the basic physiologic mechanisms of the prostaglandins in reproductive medicine. Undoubtedly, the work of Dr Ingelman-Sundberg has stimulated many of his colleagues, students, and fellow scientists to pursue such basic studies in greater details.

Abortion, Induced↗
PubMed1977

Menstrual regulation: risks and "abuses".

The definitions, methods, and techniques of menstrual regulation (MR) are presented. The risks and abuses of performing MR by vacuum aspiration to terminate pregnancies of less than 7 menstrual weeks are reviewed.

Abortion, Induced↗
PubMed1976

A standard of fetal growth for the United States of America.

The appropriate interpretation of monitored fetal growth throughout pregnancy in individual patients and populations is dependent upon the availability of adequate standards. There is no adequate standard of fetal weight throughout pregnancy that is suitable for patients in the U.S.A. To determine such a standard for infants delivered at about sea level the 10th, 25th, 50th, 75th, and 90th percentiles of fetal weight for each menstrual week of gestation were calculated from 430 fetuses at 8 to 20 menstrual weeks' gestation aborted with prostaglandins and from 30,772 liveborn infants delivered of patients at 21 to 44 menstrual weeks' gestation. Median fetal crown-to-rump lengths and crown-to-heel lengths were derived from measurements of 496 aborted fetuses of 8 to 21 weeks' gestation. Fetal weight correction factors for parity, race (socioeconomic status), and fetal sex were calculated. The derived fetal growth curves are useful for clinical, public health, and investigational purposes.

Body Height↗
PubMed1976

Intra-amniotic administration of 15(S)-15-methyl-prostaglandin F2alpha for the induction of midtrimester abortion.

To determine the practicability of administering 15(S)-15-methyl-prostaglandin F2alpha-tromethamine (15(S)-15-Me-PGF2alpha) intra-amniotically for the induction of midtrimester abortion, initially 2.5 mg. of 15(S)-15-Me-PGF2alpha was administered to 20 physically healthy gravid women, and was repeated after 24 hours in those patients who had not aborted. Within 24 hours, 65% aborted, and within 36 hours, 95% aborted. Although 67% experienced emesis, no serious complications occurred. This abortion rate is similar to that obtained with the recommended dose schedule of the dosage of prostaglandin F2alpha approved by the Food and Drug Administration and those reported with intra-amniotic administration of either hypertonic saline or urea when augmented with high, continuous, intravenous infusions of oxytocin. While the study intra-amniotic dose schedule appeared to be practicable, large, comparative studies will be necessary to determine the most satisfactory dose schedule and whether this method is more acceptable than other available methods.

Abortion, Induced↗
PubMed1976

The effect of meperidine analgesia on midtrimester abortions induced with intra-amniotic prostaglandin F2alpha.

To determine whether increased amounts of meperidine significantly affect the induction of abortion with intra-amniotic prostaglandin F2alpha, 42 midtrimester subjects were treated with an identical dose schedule of PFG2alpha and one of two dose schedules of meperidine. Although the group that received more mepridine reported severe pain less frequently, their mean and median induction-to-abortion times, cumulative abortion rate, uterine contractility, and complications were not significantly different from those of the group that received less meperidine.

Abortion, Induced↗
PubMed1976

A comparative study of intra-amniotic saline and two prostaglandin F2alpha dose schedules for midtrimester abortion.

The efficacy, side effects, and complications of two intra-amniotic PGF2alpha dose schedules and the unaugmented intra-amniotic instillation of saline are compared. All three methods resulted in satisfactory rates of abortion within a relatively short period of time and within clinically acceptable rates of complications. Each method has its advantages and disadvantages. Further large comparative studies were needed.

Abortion, Induced↗
PubMed1976

Practicability of ultrasonography for assessing fetal age and weight in early pregnancy.

This study was conducted to evaluate (1) the feasibility and accuracy of the B-Scan technique for measuring biparietal diameter (BPD) in utero, (2) the accuracy of the B-Scan technique for predicting fetal age and weight, and (3) parameters of fetal growth in pregnancies of less than 21 weeks's gestation. Forty-one subjects underwent diagnostic ultrasonography before induction of therapeutic abortion with Prostaglandin F2alpha. Following abortion, fetal crown-to-rump length (CRL), crown-to-heel (CHL), BPD, and fetal weight were measured directly. After 13 menstrual weeks' gestation the BPD could be accurately measured by ultrasound. The relationship of BPD to gestational age and fetal weight and the indices of fetal growth as measured by the CRL and CHL were established. It is concluded that ultrasound is a useful adjuvant to clinical assessment of fetal age and weight in patients form 13 to 21 menstrual weeks' gestation.

Body Height↗
PubMed1976

Laparoscopic sterilization with electrocautery, spring-loaded clips, and Silastic bands: technical problems and early complications.

Among 2283 patients, rates of technical failure, technical difficulty, and operative and early postoperative complications were evaluated for different methods of tubal occlusion at laparoscopy: electrocoagulation (980 cases), spring-loaded clip application (991 cases), and Silastic band application (312 cases). Rates of technical failure and technical difficulty at surgery were significantly higher (P less than 0.05) for the spring-loaded clip technique than for the electrocoagulation and Silastic band techniques. Mechanical and optical difficulties with the prototype spring clip applicator were the major sources of technical difficulties. Rates of operative (1.2%) and early postoperative (1.9%) complications were not significantly different for the three techniques of tubal occlusion. It is concluded that all three study techniques appear to be practical, and large, long-term, randomized, comparative studies to determine rates of failure and subsequent gynecologic problems are necessary to determine the best method of sterilization.

Electrocoagulation↗