Biomedical subjects

B S Apgar

Publications and source records attributed to B S Apgar.

24 records · Page 2Linked to original sources

PubMed1993

Spontaneous abortion.

Spontaneous abortion rates vary with maternal age, but the overall incidence is approximately 2% of clinically recognized pregnancies. The incidence of clinically unrecognized loss is approximately 20%. Most early fetal losses are caused by abnormal karyotypes. Other causes include heavy caffeine use, acute alcohol consumption, and smoking. Ultrasonographic examination, which includes yolk sac configuration and crown-rump length determination can help differentiate between normal and abnormal pregnancies. After 8 weeks' gestation, hormonal assays are decreased. Conservative management of spontaneous abortions can be considered if patients have low beta-hCG levels and no residual tissue detected using ultrasonography. Complications of spontaneous abortion include maternal death, bleeding, and infection. Consideration should be given to the psychological health of women and their partners who experience spontaneous abortion, particularly if they exhibit depression, guilt, and grief reactions.

Abortion, Spontaneous↗

PubMed1993

Ectopic pregnancy. An update on technologic advances in diagnosis and treatment.

From 1970 to 1986, the number of ectopic pregnancies in the United States quadrupled. Maternal mortality rates dramatically declined, yet the risk of dying from an ectopic pregnancy is still 10 times that associated with a term delivery and 50 times that associated with a legal elective abortion. Ectopic pregnancy can be a very difficult diagnosis to make, but advances in hCG assays and transvaginal ultrasound scanning allow the diagnosis to be made in 90% of cases before rupture. Conservative surgical and medical management are associated with success rates greater than 95% and resultant pregnancy rates of approximately 60%.

Female↗

PubMed1992

Endometriosis. Diagnostic clues and new treatment options.

Endometriosis results in significant pelvic pain, dysmenorrhea, and infertility. Recognition of the signs and symptoms of endometriosis can result in early diagnosis and treatment. Management includes surgical intervention to debulk large lesions and pharmacologic therapy to produce a medical oophorectomy. Primary care physicians should suspect endometriosis in infertile patients with pelvic pain.

Adolescent↗

PubMed1992

Diagnostic hysteroscopy.

The hysteroscope is a valuable tool for selective viewing of the uterine cavity and the endocervical canal. With smaller-diameter scopes, hysteroscopy can be performed in the office setting, often without the need for cervical dilatation or local anesthesia. Controlled-rate CO2 insufflators allow safe distention of the uterine cavity with minimal side effects. Indications for office hysteroscopy include the evaluation of abnormal uterine bleeding, genital carcinoma and infertility and the investigation of a "lost" intrauterine device. Hysteroscopy is an adjunct to endometrial sampling, dilatation and curettage, hysterosalpingography and cervical cytology.

Abortion, Missed↗

PubMed1992

Colposcopy.

Explore the source record for details and available documents.

Clinical Competence↗

PubMed1992

Loop electrosurgical excision procedure for CIN.

The loop electrosurgical excision procedure, also referred to as large loop excision of the transformation zone, is gaining acceptance in the United States as a method for treating cervical intraepithelial neoplasia. Loop excision of cervical tissue is accomplished using a high-frequency alternating current (radiofrequency) and thin wire loop electrodes. Loop excision may be in the form of simple excision of the transformation zone or electrosurgical loop conization. The specimens obtained using this technique are suitable for histologic evaluation. Loop excision, which is usually performed under local anesthesia, is associated with minimal short-term and long-term morbidity. Patient acceptance is high. Family physicians who perform colposcopy should consider using loop electrosurgical excision to treat cervical intraepithelial neoplasia in the outpatient setting.

Ambulatory Surgical Procedures↗