Biomedical subjects

C A Menihan

Publications and source records attributed to C A Menihan.

6 recordsLinked to original sources

PubMed2000

Association of interpregnancy interval with uterine scar failure in labor: a case-control study.

OBJECTIVE: The aim of this study was to determine whether a short interpregnancy interval is associated with uterine scar failure in laboring patients with previous low transverse cesarean delivery. STUDY DESIGN: This was a case-control study of uterine scar failures among laboring patients with previous low transverse cesarean delivery. Control patients underwent abdominal delivery during labor after failure of an attempted vaginal birth after cesarean delivery in the same month as case patients. RESULTS: An interpregnancy interval of <6 months was significantly more prevalent among case patients with uterine scar failure (P =.02). Mean interpregnancy interval was less in all cases of uterine scar failure (P = .06). CONCLUSIONS: Interpregnancy interval was inversely associated with likelihood of uterine scar failure during subsequent labor.

Adult↗

PubMed1996

Obstetric triage: selected clinical management strategies by nurse-midwives in an academic tertiary facility.

Within the perinatal literature, there are few reports regarding obstetric triage. The documented use of advanced practice nurses performing obstetric triage is noted in some centers. The article documents the use of nurse-midwives in performing obstetric triage in an academic tertiary facility. Selected clinical scenarios are presented, and clinical management skills are delineated.

Academic Medical Centers↗

PubMedDate not supplied

The effect of uterine rupture on fetal heart rate patterns.

The high success rate of vaginal birth after cesarean section (VBAC) and its low association with complications has led to VBACs being attempted at all types of facilities, including birth centers. It must be kept in mind that unpredictable uterine rupture can occur and that uterine rupture necessitates emergency intervention. The only reported predictable feature of fetal heart rate patterns in response to uterine rupture is the sudden onset of fetal bradycardia. Fetal patterns are presented to illustrate this finding.

Adult↗

PubMedDate not supplied

Limited sonography in collaborative midwifery practice.

In 1996, the American College of Nurse Midwives published guidelines for midwives who wish to incorporate limited third trimester sonography into their practices. First, however, certain didactic and clinical content needs to be disseminated through basic and continuing midwifery education. To assist the busy practitioner, information is offered related to recommended methods of obtaining learning validation and continuing competency in limited sonography. This article discusses various clinical situations in which the assessment and management of a patient's condition might be improved by having ultrasonographic information immediately available. In addition, selected data obtained by limited sonography that may necessitate physician collaboration are described through clinical case presentations. The pitfalls of limited sonography are also discussed by use of case descriptions detailing some of the risks inherent in performing a limited ultrasonogram. The recommendation of performing a complete uterine survey with each limited ultrasonogram is emphasized. Finally, some of the controversies surrounding routine sonography in pregnancy and sonograms for entertainment are addressed.

Adult↗

PubMedDate not supplied

Limited obstetric ultrasound in nursing practice.

During the past decade, nurses have begun to incorporate limited ultrasound into obstetric nursing practice. Guidelines have been established that provide the recommended content for the didactic and clinical preparation needed before implementing this technique. Fetal sonography provides useful information on fetal status and complements the fetal heart assessment. With appropriate education and institutional policies, nurses can enhance their role with this new skill. Acquiring an understanding of the educational and clinical guidelines for limited sonography is the first step for perinatal nurses who want to incorporate this skill into their clinical practice.

Certification↗

PubMedDate not supplied

Uterine rupture in women attempting a vaginal birth following prior cesarean birth.

OBJECTIVE: To determine (1) if there are any common features to fetal heart rates (FHR) and uterine activity patterns before uterine rupture, (2) if neonatal outcomes as reflected by cord blood gases are associated with the length of fetal bradycardia, and (3) if there is an increase in maternal and/or neonatal length of stay in women who experience uterine rupture during labor as compared with women following repeat cesarean section. METHODS: Maternal and fetal records of 11 women identified by the ICD-9 code as having had a uterine rupture between 1990 and 1995 were retrospectively reviewed. RESULTS: No one common feature in FHR patterns or uterine activity existed before uterine rupture other than bradycardia, although variable and/or late decelerations commonly preceded the bradycardia. Of the neonates, 91% had cord blood pH of <7.0 and 45% had base excess greater than 15 meq/l. Of those fetuses experiencing bradycardia, 55% had placental abruption. Maternal length of stay 5 days or greater occurred in 36% of those with uterine rupture. Seventy-three percent of the neonates required admission to the Neonatal Intensive Care Unit (NICU). Despite acidemia as shown by cord pH, none of the neonates experienced seizures or multiorgan dysfunction. CONCLUSION: There is no one specific FHR or uterine activity pattern that indicates the onset of a uterine rupture, although variable and/or late decelerations occur before the onset of an FHR bradycardia. In the present study, neonatal admissions to the NICU were increased and pH values were below 7.0 in 91% when uterine rupture occurred. A decrease or cessation of uterine tone was not observed. Maternal length of stay was slightly increased following uterine rupture.

Blood Gas Analysis↗