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Biomedical subjects

C H Hendricks

Publications and source records attributed to C H Hendricks.

At least 19 recordsLinked to original sources
PubMed1995

Cohort study of twinning in an academic health center: changes in management and outcome over forty years.

OBJECTIVE: Our purpose was to explore the management and outcomes of twin pregnancies over 40 years (1952 to 1993) within a single academic health center. STUDY DESIGN: According to a retrospective cohort design, twin pregnancies were collected and the following variables were analyzed: maternal age, parity, gestational age, birth weight, twin gender, presentation, delivery route, intervals between births, Apgar scores, and perinatal outcome. Information was broken into approximately decade-long epochs (1952 to 1962, 1963 to 1972, 1973 to 1982, 1983 to 1993) to compare trends over time. RESULTS: A total of 814 twin pregnancies were delivered. Median birth weight and gestational age decreased over time. The prevalence of > 20% birth weight discordancy was 23% and did not increase. Nulliparity increased over time but maternal age did not. Same-sex pairs were constant, as was presentation. Use of abdominal delivery and the abdominal delivery of a nonvertex second twin after vaginal delivery of the first increased in the last two epochs. Both the interval between births and the Apgar score of the second twin increased over time. Perinatal mortality of very-low-birth-weight and normal-birth-weight twins decreased over time. CONCLUSIONS: The maternal demographics of twinning changed little over 40 years. Gestational age and birth weight decreased over time because of the regionalization of perinatal care. Birth weight-specific perinatal mortality improved over time.

Adult↗
PubMed1978

Characteristics of patients with placenta previa and results of "expectant management".

To determine the differences between pregnancies complicated by placenta previa and those without placenta previa, the characteristics of 31,070 consecutive deliveries at one institution were analyzed. The philosophy of "expectant management" of the premature fetus and frequent use of cesarean section was utilized in the 185 patients with placenta previa. A higher proportion of these patients were multiparous, were older, had had previous abortions, and were carrying a male fetus or twins. The fetal and placental weights in these patients were similar to those in other patients throughout pregnancy. Rates of prematurity, antepartum and intrapartum fetal death, neonatal death, congenital abnormality, and low Apgar scores were higher among patients with placenta previa. Data were compiled in a manner that allows the obstetrician to: (1) evaluate the fetal weight and expected fetal growth; (2) estimate the probability that his patient will deliver prematurely and will deliver within the next one-, two-, or four-week interval; (3) determine the relative risks to the fetus prior to labor, during labor, and in the neonatal period at each stage of gestation.

Apgar Score↗
PubMed1976

A standard of fetal growth for the United States of America.

The appropriate interpretation of monitored fetal growth throughout pregnancy in individual patients and populations is dependent upon the availability of adequate standards. There is no adequate standard of fetal weight throughout pregnancy that is suitable for patients in the U.S.A. To determine such a standard for infants delivered at about sea level the 10th, 25th, 50th, 75th, and 90th percentiles of fetal weight for each menstrual week of gestation were calculated from 430 fetuses at 8 to 20 menstrual weeks' gestation aborted with prostaglandins and from 30,772 liveborn infants delivered of patients at 21 to 44 menstrual weeks' gestation. Median fetal crown-to-rump lengths and crown-to-heel lengths were derived from measurements of 496 aborted fetuses of 8 to 21 weeks' gestation. Fetal weight correction factors for parity, race (socioeconomic status), and fetal sex were calculated. The derived fetal growth curves are useful for clinical, public health, and investigational purposes.

Body Height↗
PubMed1976

Clinical observations with a prostaglandin-containing silastic vaginal device for pregnancy termination.

A salastic vaginal device containing either 0.5% or 1.0% concentrations of 15(s)-15 methyl prostaglandin F2 alpha methyl ester was used to induce therapeutic abortion in 22 patients at 6-16 weeks gestation. The 1.0% device appeared to be an effacious and safe method with cumulative abortion rates similar to that seen with intra-amniotic and intramuscular prostaglandin administration. The 0.5% device appears less effective. Bothersome side effects of emesis and diarrhea were seen with both devices although no serious complications occurred. Uterine activity and serum levels of 15(s)-15 methyl PGF2alpha appeared to reflect the concentration of prostaglandin in the device. The use of a prostaglandin-containing silastic vaginal device appears to be a safe method of pregnancy termination which is convenient, effective, and applicable to a broad range of gestational ages.

Abortion, Induced↗
PubMed1975

Reduction of cervical resistance by prostaglandin suppositories prior to dilatation for induced abortion.

Several recent reports citing increased rates of prematurity among women who have had induced first-trimester abortion suggest that forceful cervical dilatation may result in cervical incompetence in future pregnancy. There appear to be conflicting clinical impressions regarding the effectiveness on cervical softening and the reduction of cervical resistance produced by various prostaglandins. The development of the Electronic Force Monitor which is capable of precise measurement of the forces encountered in overcoming resistance during dilatation provided objective evidence with which to evaluate the effects of vaginally administered prostaglandin E2 and F2alpha suppositories. Suppositories were administered 3 hours prior to cervical dilatation, after which suction curettage was performed. Compared to the nonmedicated control group, patients receiving PGF2alpha suppositories exhibited greatly reduced cervical resistance, in some cases permitting direct introduction of the suction curette without need for any preliminary dilatation. Those patients receiving PGE2 suppositories showed an intermediate degree of cervical softening.

Abortion, Induced↗
PubMed1975

A residency elective in medical education.

A three-month elective in medical education was undertaken by a first-year resident to obtain a background to prepare for a potential career in academic medicine and medical student teaching. This experience, jointly sponsored by the Department of Obstetrics and Gynecology and the Office of Medical Studies of the University of North Carolina School of Medicine, permitted the resident to investigate components of the clinical teaching-learning encounter, suggest means of improving clinical instruction, and develop a series of self-instructional materials. Stemming from this experience, a workshop on clinical teaching skills for faculty and house staff has been designed, and four self-instructional units on family planning have been added to the teaching program on the Department of Obstetrics and Gynecology. Benefits to the resident of the elective are outlined, and guidelines for similar experiences are suggested.

Curriculum↗