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Biomedical subjects

C E Gibbs

Publications and source records attributed to C E Gibbs.

12 recordsLinked to original sources
PubMed1991

The challenge of care for the poor and underserved in the United States. An American College of Obstetricians and Gynecologists perspective on access to care for underserved women.

Access to pregnancy-related care for women and their infants and to reproductive health services for adolescents are significant concerns to the American College of Obstetricians and Gynecologists (ACOG). Adolescent and young adult women are among those most likely to be uninsured and lack access to health care services. Adolescent pregnancy, low-birth weight, and infant mortality remain major national burdens. The ACOG has taken the position that quality health care should be accessible to all women. The ACOG recommendations regarding health services for adolescents and the ACOG Committee on Health Care for Underserved Women's statement of principles regarding universal access for pregnancy-related care, which includes the basic scope of benefits, the characteristics of the providers, and the organization of services are described.

Adolescent↗
PubMed1986

Analysis of birth weight percentile as a predictor of perinatal outcome.

Birth weight-gestational age tables are convenient methods for the neonatal evaluation of intrauterine growth, however, the limits of acceptable birth weight for gestational age are controversial. The purpose of this study was to identify the birth weight percentiles that accurately predicted poor perinatal outcome from 28 through 41 weeks' gestational age. In a homogeneous population of 44,811 patients, the birth weight percentile that predicted poor perinatal outcome varied with gestational age. The birth weight percentile that predicted normal outcome in 80% of normal patients declined from the 55th percentile at 28 to 29 weeks to the 24th percentile at 34 to 35 weeks. From 28 through 35 weeks' gestational age, possibly owing to the confounding effects of prematurity, patients classified as normal by birth weight criteria still had a significant risk of poor outcome. After 36 weeks' gestational age, poor perinatal outcome occurred in 3.9% of patients and tended to occur at the extremes of birth weight. Classification by birth weights approximating the tenth and 90th percentiles identified a population in which the majority of the poor perinatal outcome occurred. However, poor outcome occurred in only 10% of patients with birth weights below the tenth or above the 90th percentiles. Among those with birth weights between the tenth and 90th percentiles, outcome was normal in 98%. Therefore, from 36 through 41 weeks' gestational age, the prevalence of poor perinatal outcome was low, and birth weight percentile was a weak predictor of outcome in the individual patient.

Birth Weight↗
PubMed1986

Birth weight percentile and perinatal outcome: recurrence of intrauterine growth retardation.

In 9596 patients followed throughout two pregnancies, recurrence of intrauterine growth retardation (IUGR) was evaluated as a function of previous birth weight percentile and attendant complications of pregnancy. Among 4623 patients with two uncomplicated pregnancies, the prevalence of recurrent IUGR was significantly related to the severity of growth retardation in the first pregnancy (P less than .0001). Those patients with both medical complications and IUGR in the first pregnancy remained at significantly increased risk for recurrent IUGR, even when the second pregnancy was uncomplicated. In second pregnancies, the combination of a previous history of an IUGR neonate and an additional current complication of pregnancy acted synergistically to increase the risk of recurrent IUGR to a level higher than that attributable to either risk factor alone.

Birth Weight↗
PubMed1979

A computer-based obstetric data retrieval system.

A computer-based obstetric patient data retrieval system is described which permits physicians with no prior computer knowledge or experience to access a patient data base. The advantages are minimal physician instruction, opportunity to examine maternal and neonatal outcome of defined diagnostic or therapeutic subsets of the data base, and rapid recall of individual patients' data, without need for continuous assistance from computer specialists. Disadvantages are the costs and our inability to interface our medical information with hospital business office data. Two brief examples of use of the system are provided.

Computers↗
PubMed1978

Planned vaginal delivery following cesarean section.

A program of trial labor by patients who had previously undergone one low cervical transverse cesarean section is described. Experience with 526 such patients shows that 49% delivered vaginally, doing so with slightly less morbidity and a shorter hospital stay than 108 similar patients not given a trial labor. Perinatal mortality and morbidity were unaffected by trial or route of delivery. Uterine rupture was encountered three times in the trial group and once in the nontrial patients but at no time resulted in a serious threat to the mother or child. Fertility was retained in 2 of the 4 patients. A significant increase in maternal morbidity was noted among patients whose trial labor resulted in a repeat cesarean section.

Cesarean Section↗
PubMed1976

Maternal deaths in Texas, 1969 to 1973. A report of 501 consecutive maternal deaths from the Texas Medical Association's Committee on Maternal Health.

The Texas Medical Association's Committee on Maternal Health reports its experience with 501 consecutive maternal deaths. The committee structure and procedures are explained. Demographic and pathologic data are presented and discussed. The defects which allowed complications to proceed to death are analyzed and recommendations are made to reduce the number of these deaths.

Maternal Mortality↗
PubMed1976

Nutritional beliefs and practices in primigravid Mexican-American women.

One hundred and thirty-one young Mexican-American women were interviewed and assessed nutritionally at their first obstetrical visit in a city-county hospital. About half had an intake of less than the recommended allowance for one or more nutrients or were frankly anemic, as judged by hemoglobin levels. The majority demonstrated little accurate information concerning foods as sources of nutrients. Considerable confusion was shown in their answers to questions concerning newborn birth weight, diet, and maternal weight gain. The fundamentals of prenatal education regarding nutrition for these patients must begin with foods and their relative values, emphasize the dependence of the fetus on maternal diet, and clarify the relationship of weight gain to obstetrical health. Ideally, such an educational effort should begin in early childhood.

Adolescent↗