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PubMed1985

Hypogastric artery ligation for obstetric hemorrhage.

Ligation of the hypogastric arteries has been recommended for control of obstetric hemorrhage. However, specific information regarding its effectiveness is lacking. The hospital charts of 19 patients undergoing bilateral hypogastric artery ligation for the control of otherwise intractable obstetric hemorrhage were reviewed. Indications included uterine atony (15), lateral extension of a low-transverse uterine incision (three), and placenta accreta (one). This procedure was effective in controlling bleeding in eight of 19 patients (42%). Hysterectomy was necessary in the remaining 11 patients. In these patients, blood loss, operating time, and intraoperative morbidity was increased when compared with a group of 59 patients undergoing emergency hysterectomy for obstetric hemorrhage without prior ligation of the hypogastric arteries. Surgical approaches to hypogastric artery ligation are discussed.

Arteries↗
PubMed1985

[Pharmacokinetics and clinical studies on cefminox in the field of obstetrics and gynecology].

Cefminox (CMNX, MT-141), a new cephamycin antibiotic, was studied in the field of obstetrics and gynecology, and the following results were obtained. The absorption and the penetration of CMNX into pelvic dead space exudate were good. The mean peak serum level after single intravenous injection was 190.8 micrograms/ml. The level in pelvic dead space exudate reached a peak of 36.6 micrograms/ml 4 hours after an intravenous injection of 1 g and 6.5 micrograms/ml after 12 hours, thus the level over MIC against main pathogenic organisms was maintained for a long time. CMNX was administered against gyneco-obstetrical infections such as intrauterine, intrapelvic, adnexal infections and postoperative wound infections with daily dose of 2 g and was effective in 11 cases out of 12 cases (91.7%), and 81.8% of bacteriological effect was obtained. No side effect was observed. From the above results the usefulness of CMNX in the field of obstetrics and gynecology was suggested.

Adolescent↗
PubMed1985

[Fundamental and clinical studies on cefpimizole in the field of obstetrics and gynecology].

Cefpimizole (AC-1370), a new cephem antibiotic, was studied in the field of obstetrics and gynecology, fundamentally and clinically. And the following results were obtained. The concentrations of the drug in uterine arterial and cubital venous blood, and internal genital organs following intravenous drip infusion were measured. The results demonstrated favourable transfer of the drug into the various internal genital organs. Four patients with obstetric and gynecological infections were treated with AC-1370. The therapeutic results were good in 3, and poor in 1 case, therefore the effective rate was 75%. No side effects were noted in any cases, but the severe eosinophilia (37%) was found in 1 patient. It is therefore presumed that AC-1370 is a useful drug for infectious diseases in the field of obstetrics and gynecology.

Adult↗
PubMed1984

[Fundamental and clinical studies on sulbactam/cefoperazone in the field of obstetrics and gynecology].

A combination of sulbactam, a beta-lactamase inhibitor, plus cefoperazone (SBT/CPZ = 1/1) was studied in the field of obstetrics and gynecology, and the results were following: Absorption and transfer into genital organ tissues were good. With the 1g intravenous injection the maximum serum concentrations in the uterine artery were 88.6 micrograms/ml for CPZ and 50.0 micrograms/ml for SBT, and the maximum tissue concentrations were 12.2-17.4 micrograms/g for CPZ and 9.8-21.4 micrograms/g for SBT. When the 2 g was administered, the maximum tissue concentrations were 11.9-26.7 micrograms/g for CPZ and 6.0-8.0 micrograms/g for SBT. These elimination showed the similar trend as their serum levels, and their tissue levels were higher than MIC80 for the main organisms. Their penetration into the intrapelvic dead space exudate was also good and showed that the peak levels were 30.1 micrograms/ml for CPZ and 17.4 micrograms/ml for SBT at 2 hours after the 2 g intravenous injection. The peak levels of 34.4 micrograms/ml for CPZ and 8.8 micrograms/ml for SBT at 6 hours after 2 g intravenous drip infusion were obtained. Their elimination was slow, and the concentration higher than MIC80 for main organisms was maintained for a long period of time. For gyneco-obstetrical infections such as adnexitis, intrauterine, intrapelvic and external genital organ infections, a daily dose of 2-4 g of SBT/CPZ produced a 100% clinical efficacy in 10 patients and a 88.9% bacteriological effect. The eradication ratio was more than 80% against beta-lactamase producing organisms. Side effects were few. The above results indicated that SBT/CPZ was useful in the field of obstetrics and gynecology.

Adult↗
PubMed1984

[Fundamental and clinical study of ceftriaxone in the field of obstetrics and gynecology].

Ceftriaxone (Ro13-9904, CTRX), a newly developed cephalosporin antibiotic, was fundamentally evaluated through determination of the levels in the female genital organ tissues and in the pelvic dead space exudate. CTRX was also studied on its clinical efficacy in 13 cases with gyneco-obstetric infections. The transmission of CTRX into the female genital organ tissues was favorable: the peak level in each tissue was as high as 38 to 63 micrograms/g 18 to 37 minutes after administration. The level in each tissue even after about 18 hours remained around 10 micrograms/g, suggesting its better transmission into the tissues than other drugs. The transmission into the pelvic dead space exudate was also good: the level reached a peak of 100 to 120 micrograms/ml 1 to 3 hours after administration and still ranged from 74 to 76 micrograms/ml even after about 12 hours. The clinical efficacy was excellent in 5, good in 5 and poor in 3 out of 13 cases with gyneco-obstetric infections and the efficacy rate was 76.9%. Neither adverse reaction nor laboratory test abnormality was observed in any case. The above-mentioned results suggest that CTRX is a useful antibiotic for gyneco-obstetric infections.

Adult↗
PubMed1982

[Fundamental and clinical studies on piperacillin in the field of obstetrics and gynecology].

We conducted a study on the utility in the obstetric and gynecological field of piperacillin (PIPC) which is a broad spectrum penicillin developed here in Japan. After administration of PIPC by intravenous one shot injection or intravenous dripping infusion the yield of PIPC to the various uterine tissues was a favorable 30 approximately 40% in comparison with the serum concentration and the discharge from retroperitoneum was about 100% to 300% in 4 hours. Thus it is thought to be useful in the treatment of infections of the retroperitoneum. During a clinical trial PIPC was administered to 16 patients with obstetrical and gynecological infections and it proved to be excellent in 4 patients, good in 10 patients and ineffective in 2 patients. Thus an overall efficacy rate of 87.5% was obtained. The only side effects observed was a slight transitory abnormality of liver function in 2 patients. Thus in the overall evaluation, this drug was considered to be useful in the treatment of infections in the obstetric and gynecological field.

Adult↗
PubMed1982

[Clinical study with piperacillin in the field of obstetrics and gynecology].

1. Tissue concentrations of piperacillin (PIPC) between 80 to 150 minutes after the completion of 2 g/1 hour dripping infusion were 4.6 approximately 6.4 micrograms/g in the uterus, ovary and oviduct. These concentrations were higher than 80% MIC of the causative organisms, including Staphylococcus aureus, Escherichia coli, Klebsiella, Proteus mirabilis, Bacteroides and Peptococcus, isolated from infections in the field of obstetrics and gynecology. 2. The PIPC concentration in the retroperitoneal space exudate reached a peak value of 34.7 micrograms/ml at 2 hours after the completion of 2 g/1 hour dripping infusion and thereafter maintained a constant level. These concentrations were sufficient for the therapy of parametritis. 3. We administered PIPC at 4 g per day for a period of 4 approximately 8 days to 4 patients with obstetrical and gynecological infectious diseases. All cases proved to respond effectively. No adverse effects and abnormal laboratory findings were observed. From the above, we considered that PIPC was an effective and safe antibiotic against infections in the field of obstetrics and gynecology.

Adult↗
PubMed1982

[Experimental and clinical studies of cefmenoxime in the field of obstetrics and gynecology].

The study group was organized to evaluate the usefulness of cefmenoxime (CMX) injection, a new synthetic cephalosporin, for the treatment of infections in the field of obstetrics and gynecology. Fundamental and clinical studies were made by the society and the following results were obtained. 1. The peak distribution of CMX's MIC for E. coli, Klebsiella sp., Enterobacter sp., Bacteroides sp. and Peptococcus sp. isolated from obstetrical and gynecological infections with relatively high frequencies area 0.1, less than or equal to 0.05, 0.2, 3.13, 1.56 micrograms/ml, respectively, with an inoculation of 10(6) cells/ml. 2. When 1 g of CMX is administered by intravenous drip infusion for 1 hour, the maximum concentrations in various tissues of female genital organs were as follows: 14.2 and 13.2 micrograms/g in ovary and oviduct, respectively, at 1.20 hours after the start of administration, and 16.9 and 26.3 micrograms/g in corpus uteri and cervix uteri, respectively, after 1 hour. As for the transfer to the exudate in the pelvic dead cavity, the peak concentration was 15.6 micrograms/ml after 2.13 hours. 3. In the clinical studies, CMX was given to 258 cases with female genital organ infections and others. As for the clinical effects, with exclusion of 3 cases in which other antibiotics are concomitantly used, responses were excellent in 76 cases, good in 162 cases and poor in 17 cases, among 255 cases in total. The efficacy rate was 93.3%. The efficacy rates by diseases were 97.1% (68/70) for intrauterine infections, 88.8% (79/89) for intrapelvic infections, 98.4% (62/63) for adnexitis, and 100% (23/23) for infections of external genital organs. As for the clinical effects on causative bacteria, the efficacy rates were 100% (19/19) for single infections due to Gram-positive bacteria, 94.8% (55/58) for single infections due to Gram-negative bacteria, and 88.2% (15/17) for single infections due to anaerobic bacteria. And its efficacy rates were 89.6% (69/77) for mixed infection cases. Side effects were observed in 2 cases (0.8%); 1 case with eruption, and 1 case with diarrhea and vomiting. As for abnormal laboratory findings, lower white blood cell count was observed in 2 cases and elevation of the values regarding hepatic functions in 9 cases. All cases were returned to the normal after the completion of the administration. Cefmenoxime showed a satisfactory clinical efficacy and a potent bacteriological effect in treatment of the infections in the field of obstetrics and gynecology, and it has been concluded that cefmenoxime will be useful addition to the antibiotics for the therapy of these infections.

Adolescent↗
PubMed1984

[Experience with ceftazidime in the field of obstetrics and gynecology].

Ceftazidime ( CAZ ), a new cephalosporin antibiotic, was studied for transference into tissues and clinical efficacy in the field of obstetrics and gynecology, and the following results were obtained: After one shot intravenous injection of CAZ 1 g, favourable transference of CAZ into uterine tissues was observed. While the mean serum level at 1 hour after the administration was 50.2 micrograms/ml, the levels in oviduct, ovary, endometrium, myometrium, cervix uteri and portio vaginalis were 25.9, 31.6, 24.9, 24.5, 34.2 micrograms/g and 40.6 micrograms/g, respectively. The half-life of CAZ in these tissues ranged from 1.16 to 1.65 hours while that in serum was 1.24 hours. The peak level in retroperitoneal space exudate (25.3 micrograms/ml) was obtained at 3 hours after one shot intravenous injection of CAZ 1 g. The level was still as high as 2.68 micrograms/ml even 12 hours after the administration. Out of 4 cases of obstetric and gynecological infections, 3 cases were assessable, CAZ was effective in these 3 assessable cases. Neither adverse effects nor abnormalities in laboratory findings due to CAZ were observed. Based on these results, CAZ is considered to be an highly effective antibiotic with good transference into uterine tissues and clinical efficacy in obstetric and gynecological infections.

Adult↗
PubMed1984

Septate uterus: sonographic diagnosis and obstetric complications.

The present study is a report of the authors' sonographic and obstetric experience in seven cases with anatomically confirmed partial uterine septa. Emphasis is placed on the sonographic appearance and the differential diagnosis of a uterine septum. New sonographic findings are described that can resemble the appearance of a uterine septum during pregnancy, including uterine contractions, cystic masses adjacent to the uterine fundus, and a full urinary bladder. Obstetric complications are compared with previous studies. The authors observed one major obstetric complication of fetal malpresentation.

Adult↗
PubMed1983

Considerations about our approach to obstetric psychoprophylaxis.

Usually the term "obstetric psychoprophylaxis" refers to a specific method or technique. We prefer to consider it as a procedure that involves on one side the woman, the child and its family, and on the other the services entitled to give pre- and post-natal assistance. In order to realize this, a reformation of our methodological parameters and a critical analysis of the results obtained are required. In the courses of obstetric psychoprophylaxis that are held in the Department of Obstetrics and Gynaecology of the University of Padua we take into consideration the following themes: - Methodological approach - Professional training of the staff - Significance of psychosocial culture in the management of the pregnancy by the health services.

Female↗
PubMed1983

[Clinical evaluation of cefroxadine in the field of obstetrics and gynecology].

Clinical studies of cefroxadine (CXD), a new orally active of cephalosporin, in obstetrical and gynecological field were performed, and the results were summarized as follows. CXD was orally administered to 16 cases of obstetrical and gynecological infections in daily dose 750 approximately 1,500 mg. Clinical efficacy was 88.9% in endometritis (9 cases), 100% in cervicitis (2 cases), 75% in adnexitis (4 cases) and 100% in suppurative haematoma vulva (1 case), respectively. Overall efficacy was 87.5% (14/16). Clinical efficacy classified by caused organisms was 83.3% (10/12) overall, and bacteriological effect was 91.7% (11/12). Neither side effects nor abnormalities in laboratory findings caused by this drug were observed. Based on these results, CXD should be considered a very safe and useful drug for treating obstetrical and gynecological infections.

Administration, Oral↗
PubMed1983

[Bacteriological and clinical evaluation of cefoxitin in the treatment of infections in 39 obstetric and gynecological patients].

A total of 39 patients was admitted to the obstetric and gynecological wards of Nagoya University Hospital and the University's 5 related hospitals during the period from July 1981 to March 1982. The efficacy of cefoxitin sodium was evaluated in the 39 patients with a wide variety of obstetric and gynecological infections. The findings are the follows: Of the 39 patients, the responses in 7 were judged "excellent", 28 "good" and 4 "poor" with the clinical efficacy rate of 89.7%. The causative pathogens in 23 of the cases were isolated from clinical materials submitted to the Institute of Anaerobic Bacteriology, School of Medicine, Gifu University. In these 23 cases, it was found that 8 were due to aerobic bacteria only (34.8%), 8 mixed aerobic-anaerobic bacteria (34.8%) and the remaining 6 anaerobic bacteria only (26.1%), i.e. a substantial percentage (60.9%) was due to anaerobic bacteria or mixed aerobic-anaerobic bacteria. Cefoxitin was active against most strains of Bacteroides spp. and was not affected by the inoculum size. On the other hand, most strains of Bacteroides spp. were resistant to cefazolin when the inoculum size was increased from 10(6)/ml to 10(8)/ml. Lincomycin was also found to be active against many fo the strains of Bacteroides spp. Cefoxitin and cefazolin were fairly active against anaerobic bacteria other than Bacteroides spp., while these same bacteria were resistant to sulbenicillin and many of them showed resistance to lincomycin. Cefoxitin was well tolerated and no untoward side effects were observed. The clinical and bacteriological results indicate that cefoxitin is a very effective antibiotic in the treatment of a wide variety of obstetric and gynecological infections and is a suitable choice as initial antibiotic therapy in these conditions.

Adolescent↗
PubMed1980

[Fundamental and clinical studies on cefamandole in the field of obstetrics and gynecology (author's transl)].

1) Tissue concentrations of cefamandole (CMD) one hour after the end of 2 g/30 approximately 60 minutes drip infusion were 7.3 approximately 13.1 microgram/g in uterus, ovary and oviduct. These concentrations were higher than MICs of 70 approximately 100% of causative organisms, including Staphylococcus aureus, Escherichia coli, Klebsiella, Proteus mirabilis, Enterobacter and Citrobacter, isolated from the infections in the field of obstetrics and gynecology. 2) CMD was administered to 14 patients with moderate infections in the field of obstetrics and gynecology at a daily dose of 4 g for 5 approximately 7 days. The overall clinical efficacy obtained was as follows; excellent in 7 cases (50%), good in 3 cases (21%) and poor in 4 cases (29%). 3) Antimicrobial activity of CMD against causative organisms resembled that of CEZ. 4) No adverse effects and abnormal laboratory findings were observed. From the above, we considered that CMD was an effective and safe antibiotic against infections in the field of obstetrics and gynecology.

Adult↗
PubMed1982

Serial first morning estriol determinations in evaluating the high-risk obstetric patient.

Over the past decade, 24-hour urinary estriol determination has become an integral part of the evaluation and monitoring of high-risk obstetric patients for fetal well-being. This study was undertaken to assess the utility of estriol determinations obtained by simpler collection methods: serum estriol and first morning urine specimens. Serum estriol proved to be an unreliable predictor of 24-hour urine values and of estriol fluctuations. Although the correlation between first morning and 24-hour primary estriol:creatinine ratios was statistically significant (P less than .0001), any single first morning specimen value chosen at random was a poor predictor of the corresponding 24-hour specimen value. However, in the monitoring of high-risk obstetric patients, it is the significant changes with respect to time rather than the absolute estriol levels that are of interest. As the plots of first morning and 24-hour specimen values with respect to time in 8 subjects exhibit time trends of equivalent diagnostic utility, it it concluded that first morning values may be used in place of 24-hour values to monitor high-risk obstetric patients, making the process simple and quicker.

Creatinine↗
PubMed1981

[Central venous catheterization using ECG monitoring and its obstetrical application (author's transl)].

We tried the central venous catheterization using the ECG monitoring lead by the catheter tip without the X-ray examination. The catheter consists of 5F sized, 70 cm, thin-walled polyethylene tube. The apex of the catheter is 60 degrees curved with heating and the exchangeable metal adaptor is attached in the proximal end. The catheter was introduced percutaneously into the cubital vein and filled with saline. The ECG lead from the catheter tip was recorded through the metal adaptor by the battery electrocardiograph. The introduction into the right atrium of the catheter was easily judged in almost all cases by the intraatrial ECG, namely, deep negative or biphasic P wave. We have tried this method in 72 cases and the success rate of insertion into the right atrium was as high as 87.5%. The right atrial pressure of the obstetrical group (19 term pregnant women) was significantly lower than that of the gynecological group (22 preoperative patients) (P less than 0.01). The pH of the right atrial blood in the obstetrical group was significantly higher than that in the gynecological group (P less than 0.01). PCO2, PO2, HCO3-, and the oxygen saturation of the obstetrical group were significantly lower than those of the gynecological group (P less than 0.01).

Adult↗
PubMed1995

[Experience with autologous transfusion in obstetrics].

The consequences of homologous blood transfusion have a remarkable impact on the obstetric population which mainly consists of young healthy women. The risk involved in possible post-transfusion complications is directly proportional to the number of homologous blood units that are being transfused. Autologous transfusion is riskless for the fetus' well being. The main obstetrical problem is that it is impossible to foresee to the maximum extent all cases in need of blood transfusion which might get either an excessive amount or an insufficient amount of autologous transfusion. Blood predonation is the most suitable method in the obstetrics service. Reported below are the findings concerning the autologous transfusion experience performed by the OB/GYN Department at the Hospital San Daniele del Friuli, Udine for the period 1989-1993, where a new method of autologous donation was performed on 44 pregnant women who delivered by C-section. The autologous program is considered an easy one in the OB/GYN field, without complications for the fetus' well being and also feasible for small hospitals.

Blood Transfusion, Autologous↗
PubMed1994

[Seroprevalence of hepatitis C virus antibodies in obstetric patients at the Nuevo Hospital Civil de Guadalajara].

The hepatitis C virus is the predominant cause of parental transmission of hepatitis. The importance to recognize the prevalence of this virus in obstetrics patients is the possible vertical transmission of mother to child which has been reported by various authors. The objective of this investigation was to determine the presence of antibodies of the hepatitis C virus in the obstetrical population of the Nuevo Hospital Civil de Guadalajara. Selection was made at random; questionnaires were applied to identify factors of associated risks. Of the 244 patients studied, the prevalence was found in 2% (n = 5). The only risk factor closely related was previous blood transfusion (P < 0.00004964) with a relative risk of 29.6 for the obstetrics population with previous transfusion.

Adolescent↗