Cervical mucus enzymes as markers of the woman's fertile period.
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Adult↗
Biomedical subjects
W N Spellacy
Publications and source records attributed to W N Spellacy.
Glucose and insulin levels after six months of treatment with a triphasic oral contraceptive containing ethinyl estradiol and norethindrone.
A prospective study of carbohydrate metabolism was done on 33 women who used a triphasic oral contraceptive (OC) containing ethinyl estradiol and norethindrone for six months. A three-hour oral glucose tolerance test was administered before and after the OC usage, and both the blood glucose and insulin levels were determined. A significant decrease in the fasting glucose level was found with treatment. All other glucose values and insulin levels were unchanged.
Adult↗
Pregnancy outcomes in short women.
The pregnancy outcomes in 3,059 women who were 122-152 cm (48-60 in) tall with singleton pregnancies were compared to those of 7,414 women who were 160 cm (63 in) tall. The short women were of lower weight at delivery and had slightly higher parity. There were fewer whites in the short group. The higher parity was associated with a slightly higher occurrence of placenta previa. The pregnancies in the short women were characterized by smaller infants and more frequent delivery by cesarean section, depending on race. For whites the cesarean section rate was 43% in the very-short group (122-136 cm, or 48-53 in), 35% in the short group (137-151 cm, or 54-59 in) and 23% in the control group. The results suggest that women less than 152 cm (60 in) tall are a high-risk group.
Birth Weight↗
Plasma glucose and insulin levels in women using a levonorgestrel-containing triphasic oral contraceptive for three months.
Plasma glucose and insulin levels were measured for three hours after an oral glucose challenge in twenty-nine women before and after using a triphasic oral contraceptive containing ethinyl estradiol and levonorgestrel for three months. There were significant elevations in the glucose levels during the three-month tolerance test, while the insulin levels were unchanged. These data suggest that this OC can alter carbohydrate metabolism and that long-term studies are needed to assess the extent of this metabolic change.
Adolescent↗
Prospective study of carbohydrate metabolism in women using a triphasic oral contraceptive containing norethindrone and ethinyl estradiol for 3 months.
Thirty-five women with normal carbohydrate metabolism were administered a 3-hour oral glucose tolerance test before and after 3 months' use of a triphasic oral contraceptive that contained ethinyl estradiol and norethindrone. The results show no significant change in either the plasma glucose or the insulin values. This is the first published study with regard to this type of triphasic oral contraceptive, and the study supports claims of the preparation's improved safety.
Adolescent↗
Prostaglandin production and contractile response of umbilical arteries in preeclamptic pregnancies with and without intrauterine growth retardation.
Biochemical and biophysical properties of umbilical arteries from normotensive and preeclamptic pregnancies were examined. The production of prostaglandins E and F, 6-keto-PGF1 alpha, and thromboxane B2 by umbilical arteries from normotensive, mildly preeclamptic, and severely preeclamptic pregnancies were measured in incubation media at baseline and after addition of arachidonic acid. The initial baseline values of 6-keto-PGF1 alpha were decreased in the severely preeclamptic patients with intrauterine growth retardation (IUGR) but not in any of the other groups. Addition of arachidonic acid resulted in a significant increase in 6-keto-PGF1 alpha production over initial baseline in all groups except in the severely preeclamptic pregnancies without IUGR. These results suggest a differential defect in the 6-keto-PGF1 alpha metabolic pathway in severely preeclamptic patients with IUGR compared with those without IUGR. The stretch response curve to serotonin was decreased in the severely preeclamptic group with IUGR compared with the control group. The contractile response to individual vasoactive agents (serotonin, prostaglandin F2, norepinephrine, angiotensin II, and arachidonic acid) showed no significant difference between the normotensive and preeclamptic groups.
Angiotensin II↗
Antepartum complications in twin pregnancies.
Women with twin pregnancies have some unique problems and some that occur more frequently than those seen in singleton pregnancies. Examples of the former are the vanishing twin and death of one fetus. Examples of the latter are congenital anomalies, hydramnios, hypertension, and anemia. Prenatal care must be altered because of these complications, and perinatal morbidity and mortality are increased.
Anemia↗
Maternal risk status and postdate pregnancy outcome.
Using a 1982-1985 regional perinatal network data base of 69,746 infants, a retrospective study was conducted to compare the perinatal outcome of 7,729 postdate infants (greater than or equal to 42 weeks' gestation) by maternal risk status. Due to additional antenatal complications, of which 8.0% were hypertension and/or diabetes, 48.4% of the postdate pregnancies were classified as at risk. As expected, high-risk women experienced a higher incidence of adverse perinatal outcomes than did low-risk women. The incidence of meconium staining, low five-minute Apgar scores and perinatal mortality increased beyond term and was found most commonly in infants from high-risk pregnancies, especially those involving hypertension and diabetes mellitus. These results suggest that high-risk pregnancies probably should not enter the postdate period since their doing so places the infant at serious risk.
Adult↗
Neonatal seizures after cesarean delivery: higher risk with labor.
A study was done on the occurrence of neonatal seizures in 14,367 infants delivered by cesarean section in a perinatal region in 4 years. Although seizures occurred in 1% of all of these infants, small infants weighing less than 2500 gm at birth had the highest frequency (greater than 4%). Term infants delivered before labor (repeat cesarean section) had the lowest seizure rate (less than 0.2%), and this was a significantly lower (four times) frequency than that seen in term infants delivered by primary cesarean section. These data suggest that brain function as indexed by neonatal seizures can be adversely affected during labor.
Cesarean Section↗
Postdate pregnancies: a review of 46 perinatal deaths.
A review of 46 perinatal deaths was conducted using a 1982 to 1985 regional perinatal network database of 6701 delivered postdate (greater than or equal to 42 weeks gestation) infants. Perinatal mortality (6.9 per 1000 births) increased as gestational age advanced beyond 42 weeks, and was higher in young teenagers or mothers with some additional antenatal complications, such as hypertension. Meconium staining of the amniotic fluid, low Apgar scores, low birthweight, congenital malformations, and neonatal complications, including pneumothorax, meconium aspiration, and seizures, were associated with perinatal death.
Female↗
Survey of departments of obstetrics and gynecology in U.S. and Canadian medical schools, 1965 to 1985.
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Adult↗
Effect of gestational age on baseline fetal heart rate during the third trimester of pregnancy.
Analysis of the fetal heart rate in 3,127 reactive nonstress tests revealed that the baseline rate decreased significantly between 28 and 41 weeks' gestation (6.4 beats per minute [4.5%]). Analysis of 235 women with two tests at least four weeks apart revealed that while the majority (51.1%) demonstrated a decrease, 26.8% experienced a rise in the baseline rate during the testing interval.
Female↗
Perinatal morbidity and mortality in a regional perinatal network.
A study of pregnancy outcome was performed using a 1982-1985 regional network database of 60,456 infants. The perinatal mortality rate was 15.6 deaths per 1,000 births (total, 942), while the antepartum, intrapartum and neonatal mortality rates were 5.3, 1.6 and 8.7, respectively. Seven hundred forty-three multiple gestation pregnancies (1.2%) and 1,632 major congenital anomalies (2.7%) were identified. The corrected perinatal mortality rate was 13.8 deaths per 1,000 births. This study revealed that prematurity, postdatism, congenital anomalies, low Apgar scores and neonatal complications, including respiratory distress syndrome, pneumothorax, persistent fetal circulation, intracerebral hemorrhage and seizure activity, were major factors contributing to mortality. This analysis suggests that a further reduction in mortality should follow a reduction in preterm deliveries and their sequelae and the early identification and management of maternal and fetal antenatal complications.
Female↗
Thermic effects of tocolytic agents: decreased temperature with magnesium sulfate.
The effect of the tocolytic agents terbutaline and magnesium sulfate on patients' temperatures was examined. Fifty-two women admitted for preterm labor were randomized to a treatment protocol for one of the two agents. Oral temperatures were measured initially and every two hours during treatment. There was no significant difference between the initial temperature and the lowest temperature recorded during treatment in the terbutaline group, but temperature decreased significantly during treatment with magnesium sulfate. This decrease in maternal temperature may have importance in the treatment of preterm labor with magnesium sulfate in patients with an infectious etiology for uterine activity.
Adult↗
Perinatal characteristics of uncomplicated postdate pregnancies.
Using a regional perinatal network database of 60,456 births, a study compared 3457 postdate (42 weeks or longer) infants to a control group of 8135 infants born at 40 weeks' gestation from 1982 through 1985. Both patient groups included only uncomplicated pregnancies. Although the differences were small, women who delivered postdate infants had a lower parity, higher weight at delivery, and higher blood pressure during pregnancy than controls. The postdate infants were heavier, more likely to be delivered by forceps or cesarean section, and more likely to experience shoulder dystocia. They also had lower Apgar scores and more meconium aspiration and congenital malformations. Although the overall perinatal mortality was not statistically different, the higher perinatal morbidity in postdate infants suggests that careful attention should be paid to this high-risk problem.
Apgar Score↗
Student response to gynecologic teaching associates.
Gynecologic teaching associates teach the communication and psychomotor skills for breast and pelvic examinations in most medical schools in the United States and Canada. Evaluations of these gynecologic teaching associate programs have included faculty impressions of program effectiveness and measurement of student retention of skills but not student evaluations of the effectiveness and value of such programs. At the University of Illinois at Chicago students evaluated their gynecologic teaching associate program. High ratings were given to program organization and content; the knowledge, ability, and professionalism of the teaching associates; and the outcomes of the sessions with respect to the learning skills needed to perform the examinations. Students emphasized the importance of the ability of the teaching associates to provide immediate informative feedback and to reduce anxiety during the teaching sessions. Students tended to view their ability to perform breast examination to be greater than for the pelvic examinations but felt they learned more about both in the sessions. This information supports the value of the gynecologic teaching associate model in medical education.
Breast↗
Cervicovaginal peroxidases: markers of the fertile period.
The specific activity of guaiacol peroxidase was measured daily in human cervical mucus, vaginal fluids, and saliva during 45 cycles in 31 women. Also determined were basal body temperatures and serum hormones (luteinizing hormone [LH], estradiol, progesterone). The guaiacol peroxidase was extracted with 0.5 M CaCl2 and thus may be a different peroxidase from that obtained by noncalcium extraction procedures. The guaiacol peroxidase specific activity did not vary in the saliva during the cycle but fell sharply in the cervical mucus and vaginal fluid four to five days before the ovulation time, estimated by the LH peak, and rose again one to two days after ovulation. Anovulatory cycles did not show the midcycle drop in guaiacol peroxidase. Growth curve analysis gave excellent fitting of the guaiacol peroxidase data to a polynominal model. These data suggest that cervicovaginal guaiacol peroxidase may be clinically useful in detecting the fertile period for population control and for infertility treatment.
Adult↗
Organizing a search for an academic administrator.
The search for new administrators in complex systems is an important activity. The special requirements of academic organizations, particularly those with health centers, present some unique considerations that can confound this important and difficult process. Typically, national searches attract a sizable candidate list composed of persons with diverse backgrounds and experiences, and a committee is empowered to sort through their qualifications. A critical step in the planning of each search is the development of a process that allows participatory decision making while not requiring too much time. Too often the search becomes an unmanageable activity that confuses the searchers and frustrates the administration. A seven-step process has proven successful for use by committees to attract and sort through written candidate applications, to agree upon a preliminary ranking of candidates and to reach a consensus on a final list of recommendations. The process could be applied in almost any organizational setting.
Administrative Personnel↗