ABSTRACT
The California Diabetes and Pregnancy Program (CDAPP) began in 1984 as a multicenter, collaborative project with support provided by the state Department of Health Services, Maternal and Child Health Branch. Between its inception and 1988, it expanded from three to eight perinatal regions, making the CDAPP model of care available to patients in 19 clinical affiliate sites. The care was provided by a multidisciplinary team composed of physicians, a diabetes educator, a registered dietician, a social worker, and appropriate consultants. The elements of this model of care included comprehensive patient education, active patient participation in care, maternal and perinatal medical assessment, and collection of standardized patient information adequate to allow a programmatic and medical evaluation of the CDAPP. Despite impressive growth of the program by December 1988, statewide implementation of CDAPP is incomplete.
Subject(s)
Diabetes, Gestational/therapy , Pregnancy in Diabetics/therapy , Adolescent , Adult , California , Cohort Studies , Female , Humans , Patient Care Team , Patient Education as Topic , Pregnancy , Prenatal Care/methods , Prospective Studies , Weight GainABSTRACT
A random comparison of clindamycin-gentamicin (C-G) and penicillin-gentamicin was made in 200 women who developed endomyometritis following cesarean section. All pretreatment profiles indicated similar populations. The clinical response was more favorable in the women receiving clindamycin-gentamicin. The implications of these results upon clinical practice is discussed.
Subject(s)
Clindamycin/administration & dosage , Endometritis/drug therapy , Gentamicins/administration & dosage , Penicillins/administration & dosage , Postoperative Complications/drug therapy , Puerperal Infection/drug therapy , Adult , Cesarean Section , Drug Therapy, Combination , Endometritis/etiology , Female , Humans , Myometrium , Pregnancy , Puerperal Infection/etiologyABSTRACT
The role of antibiotic prophylaxis in women undergoing vaginal hysterectomy is reviewed. Although there has been a wide range in the reported incidence of postoperative infection and a wide variation in the definition of infectious morbidity, all of the reported studies to date have shown a decrease in the number of infections with this regimen. Currently, a short perioperative course with the cephalosporins is recommended for patients not allergic to penicillin, and this continues to be effective. A short alternative regimen for the penicillin-allergic patient has not been studied as yet.
