ABSTRACT
The present study described the effectiveness of using an educational program for self-detection of premature labor in a group of forty-one indigent pregnant adolescents. Twenty-one of these teens self-detected premature labor and received appropriate medical intervention; only four had low birthweight infants and three delivered before 37 weeks. The overall results showed a significant use of the program and a high success to failure rate for those who received medical intervention. The cost-effectiveness and usefulness of this protocol in improving medical outcome for indigent teens are discussed.
Subject(s)
Obstetric Labor, Premature/prevention & control , Patient Education as Topic/methods , Pregnancy in Adolescence , Adolescent , Decision Trees , Female , Humans , Medical Indigency , Obstetric Labor, Premature/diagnosis , Pregnancy , Program Evaluation , Self Care , Urban PopulationABSTRACT
Maternal immunization with the capsular polysaccharide (PRP) vaccine of Haemophilus influenzae type b has been shown to extend the time that protective levels of maternal antibody are detected in infants. In a randomized, blinded trial, PRP or placebo was administered uneventfully to 213 women in the third trimester of pregnancy. Infants born to PRP recipients had significantly higher levels of antibody to PRP than did infants born to placebo recipients: 2.73 micrograms/ml compared with 0.33 microgram/ml. It was estimated that infants of mothers who received the PRP vaccine would be protected for an average of 4 months compared to an average of only 2 months for those of mothers who received placebo. Infants were followed for invasive H. influenzae type b disease through the first year of life; none was detected.
Subject(s)
Bacterial Vaccines/administration & dosage , Haemophilus Infections/prevention & control , Haemophilus Vaccines , Haemophilus influenzae/immunology , Immunity, Maternally-Acquired , Immunization/methods , Polysaccharides, Bacterial/administration & dosage , Antibodies, Bacterial/blood , Bacterial Capsules , Bacterial Vaccines/immunology , Double-Blind Method , Enzyme-Linked Immunosorbent Assay , Female , Fetal Blood/immunology , Follow-Up Studies , Humans , Immunoglobulin G/biosynthesis , Immunoglobulin G/blood , Infant, Newborn , Polysaccharides, Bacterial/immunology , Pregnancy , RadioimmunoassayABSTRACT
Maternal mortality in a large, tertiary-care, intensive care, referral center was reviewed for a six-year period. The first three years of the review were prior to the institution of a maternal-fetal medicine intensive care unit, located in the labor-and-delivery suite. The subsequent three years encompassed a period during which an intensive care unit staffed by maternal-fetal medicine specialists and obstetric anesthesiologists was established in the labor-and-delivery suite. The maternal mortality rate was 21.7/100,000, or 10 maternal deaths in 45,984 deliveries, prior to establishment of the unit and 22.1/100,000, or 11 maternal deaths in 49,700 deliveries, after establishment of the unit. The major causes of maternal mortality were pregnancy-induced hypertension, hemorrhage and infection. It appears that a multi-disciplinary team composed of maternal-fetal medicine specialists and obstetric anesthesiologists can provide the same level of care for critically ill obstetric patients that traditionally would be provided by medical intensive care specialists.
Subject(s)
Intensive Care Units/statistics & numerical data , Maternal Mortality , Adolescent , Adult , Female , Humans , Infections/mortality , Postpartum Hemorrhage/mortality , Pre-Eclampsia/mortality , Pregnancy , Respiratory Distress Syndrome/mortality , Retrospective Studies , TexasABSTRACT
A case of a poorly differentiated adenocarcinoma of the lung associated with pregnancy is presented with emphasis on the intense interdisciplinary team work required in order to achieve the optimal outcome of pregnancy.
Subject(s)
Adenocarcinoma/therapy , Lung Neoplasms/therapy , Pregnancy Complications, Neoplastic/therapy , Adenocarcinoma/drug therapy , Adenocarcinoma/radiotherapy , Adult , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Combined Modality Therapy , Female , Humans , Infant, Newborn , Lung Neoplasms/drug therapy , Lung Neoplasms/radiotherapy , Male , Parenteral Nutrition, Total , Pregnancy , Pregnancy Complications, Neoplastic/drug therapy , Pregnancy Complications, Neoplastic/radiotherapySubject(s)
Estriol/analysis , Placental Function Tests/methods , Saliva/analysis , Female , Humans , PregnancyABSTRACT
A prospective comparison of ultrasound-directed second-trimester genetic amniocentesis to blind amniocentesis showed a significant reduction in the incidence of both bloody taps and failed amniocentesis. The incidence of other parameters, such as fetal outcome, failed culture of amniotic fluid fibroblasts and spontaneous abortion, was similar. These data support the use of amniocentesis under ultrasound control as a routine component of prenatal genetic diagnosis.
Subject(s)
Amniocentesis/methods , Ultrasonography , Abortion, Spontaneous/epidemiology , Female , Genetic Counseling , Humans , Pregnancy , Pregnancy Trimester, SecondABSTRACT
Fetal ascites not associated with Rh incompatibility is an uncommon problem that can be detected in utero by sonography. The sonographer should make a systematic search for the cause of ascites in a given case on the basis of well known etiologic possibilities, since this may have a significant effect on the obstetrical management. The use of sonography in the detection, etiologic evaluation, and obstetrical management of nonimmunologic fetal ascites is discussed, and experience with 10 such cases is reported.