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Biomedical subjects

B N Barwin

Publications and source records attributed to B N Barwin.

6 recordsLinked to original sources

Recent advances in the pharmacologic regulation of fertility in men.

An updated review of research into contraceptives for men is presented. New concepts of the pharmacologic effects of chemical agents on germinal stem cells and spermatogenic arrest, and the effect of new compounds that act at the post-testicular level but do not affect androgen production are discussed. The latest results of studies on steroidal compounds that inhibit pituitary secretion of gonadotropin and hence result in suppression of spermatogenesis and testosterone secretion are presented. The newer contraceptive pills for men are also evaluated. The major drawback to the development of chemical contraceptives for men is the fear of genetic damage and impotence. New and continued research into this type of contraception is urgently needed.

Alkylating Agents

Labour: when to worry.

To ensure an optimum result in pregnancy it is essential that the physician be alert in the antenatal period to recognize those women and their babies who are at risk during labour. Premature labour, with its attendant risk of respiratory distress syndrome in the newborn, continues to be an important factor in perinatal morbidity and mortality. Early recognition of predisposing factors and the judicious use of myometrial inhibiting agents have helped to reduce the incidence of fetal prematurity in these cases. A long interval between rupture of the membranes and delivery continues to be a danger to both mother and fetus. Delivery is recommended when gestation is beyond 36 weeks or when there are signs of incipient infection, and once labour has begun antibiotics should be used prophylactically. Failure of labour to progress should be recognized and managed aggressively in its early stages. Amniotomy and oxytocin infusion have reduced considerably the incidence of prolonged labour and its risks to both mother and fetus. The role of intrapartum monitoring of the fetal heart rate, measurement of the pH in the fetus's scalp blood and assessment of amniotic fluid is discussed, as is the monitoring of maternal well-being.

Amniotic Fluid

The intrauterine contraceptive device.

This presentation brings into perspective the most recent information on intrauterine contraceptive devices. A comprehensive review of the literature is presented in a manner meaningful to the clinician. The advantages and disadvantages of this method of contraception, the problems that arise and the recommended methods of management are discussed. An updated review of the literature with regard to bleeding, pain, expulsion of the device, infection, uterine perforation and pregnancy is also presented.

Female

Graphic monitoring of labour.

The parturograph is a composite record designed for the monitoring of fetal and maternal well-being and the progress of labour. It permits the early recognition of abnormalities and pinpoints the patients who would benefit most from intervention. Observations are made from the time of admission of the mother to the caseroom and recorded graphically. Factors assessed include fetal heart rate, maternal vital signs and urine, cervical dilatation, descent of the presenting fetal part, and frequency, duration and intensity of uterine contractions.

Cervix Uteri

Venous distensibility during pregnancy determined by graded venous congestion.

The increase in volume of the human calf and forearm during pregnancy resulting from graded venous congestion has been measured plethysmographically in the raised leg and forearm of 10 recumbent subjects during and after pregnancy. Normal pressure volume curves were determined and the alterations in this curve over the various stages of gestation were presumed to indicate an alteration in the distensibility of the capacity blood vessels. This distensibility was found to increase with the progression of pregnancy in both the forearm and the calf particularly after the thirtieth week of pregnancy. The distensibility, however, appeared to return to below the 10 week gestation level at the eighth postpartum week. The increase in distensibility was greater in the calf than in the forearm although both were significantly increased.

Adult

Psychological factors: counseling and motivation of the contraceptive patient.

The stronger the desire to avoid conception, the more effective the contracepting. But motivation alone will not ensure success. Knowledge of all aspects of contraception is a prerequisite for optimal decision making, and such information and counseling should be readily available to all persons of reproductive age who are concerned about the use of medication, potential side effects and subsequent fertility. The counsel and opinion of physicians are sought with as much or greater frequency as their diagnostic or therapeutic skills. Yet, too often, the physician's attitude toward contraceptive use by others is colored by his own moral, religious or social philosophy. Subtle personality traits of the patient and attitudes of her partner control contraceptive disuse, misuse or rejection in most people. In the author's opinion, compliance with the use of contraception is directly related to the amount and intensity of counseling and the degree of motivation provided by the physician.

Contraception