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Biomedical subjects

E G Robertson

Publications and source records attributed to E G Robertson.

At least 19 recordsLinked to original sources
PubMed1986

A birth center affiliated with the tertiary care center: comparison of outcome.

A matched pair study compares 250 low risk women delivered in a tertiary care center with a similar group cared for and delivered in an affiliated birth center. The patients could be matched in every respect with the exception of educational background. Twenty-one percent of the birth center patients required transfer to the hospital during the intrapartum period. Differences were found in cervical dilatation upon admission and length of labor. Intermittent fetal heart auscultation was used exclusively in birth center mothers, oral fluids and light diet were allowed. The hospital group received intravenous fluids. Oxytocin augmentation was used twice as often, and the incidence of shoulder dystocia appeared significantly higher in the control group. The reasons for transfer are described. The one neonatal death was due to persistent fetal circulation.

Adolescent↗
PubMed1983

Placental injection studies in twin gestation.

Vascular communication between placental vessels can occur when there is a fused placental mass in twin gestation. The presence of anastomotic channels can lead to the twin-twin transfusion syndrome in the fetuses. A study was conducted on 278 twin pairs to determine the incidence of vascular communication in fused twin placentas and the frequency of twin-twin transfusion syndrome. Anastomotic communication was found almost universally in monochorionic placentation and very rarely with dichorionic placentas. Twin-twin transfusion syndrome occurred uncommonly despite the high frequency of occurrence of cross-placental vascular communication. Misdiagnosis of intrauterine growth retardation in one twin can be avoided by determination of chorionicity by inspection of the placentas of twin gestation.

Chorion↗
PubMed1978

Effects of steroids on serum lipids and serum cholesterol binding reserve.

Serum cholesterol binding reserve (SCBR) denotes the capacity of serum to solubilize additional cholesterol. It as been shown previously that a decrease of the SCBR in the presence of elevated cholesterol and/or triglyceride levels is associated with the development of coronary artery disease in man. This is a preliminary report of the effect on serum lipids and SCBR by alteration of the sex steroid environment in women. The hormonal changes associated with pregnancy appear to elevate cholesterol, triglycerides, and SCBR, SCBR being elevated to the greatest extent. No differences were observed in SCBR and serum lipids in a short-term study of premenopausal women when values prior to castration are compared with values after castration during administration of conjugated equine estrogens. In women observed over a period of over 20 weeks, who were using a combination oral contraceptive pill with 1 mg. of norethindrone and 50 or 80 mcg. of mestranol, there was a significant elevation of triglycerides, some decrease of cholesterol, and no change in the SCBR. The possible significance of these findings in relation to the risk of coronary heart disease deserves further investigation.

Adolescent↗
PubMed1978

Asessment of fetal gestational age in high-risk pregnancies by amniotic fluid analyses and ultrasound mensuration.

Maturity studies are reported on 204 women with high-risk pregnancies. Estimates of fetal maturity were made prenatally by the use of ultrasonic measurements, the lecithin/sphingomyelin (L/S) ratio, and a gestational index based on amniotic fluid creatinine, urea nitrogen, and cytology. These estimates were compared with the neonatal pediatric estimate of maturity. The gestational score agreed with pediatric maturity to within 14 days in 95 per cent of the cases. Estimates of L/S ratio distinguished between mature and immature infants in 86 per cent of the cases. Ultrasound could estimate gestational age only to within 14 days in 75 per cent of the cases, and the disagreements were greatest where either growth retardation or macrosomia was present. However, ultrasound is more useful in estimating fetal size and abnormalities of growth pattern. An estimate of gestational age by gestational score aids management, particularly where growth retardation is present, enabling a decision about delivery to be made even though the infant is very small and has an immature L/S ratio.

Amniocentesis↗
PubMed1976

Intrauterine transfusion in the management of severe rhesus isoimmunization.

In the ten years between 1965 and 1974, 2227 patients with rhesus isoimmunization were seen at the Newcastle centre. The antibody titre and previous history were the basis on which patients were selected for amniocentesis and determination of the amniotic fluid bilirubin ratio. There were 288 patients with a bilirubin ratio which was greater than 1-1: of these 206 were treated by intrauterine transfusion (IUT). Evidence for the belief that the treated and untreated groups were similar is presented. The overall survival rates were 44 per cent for cases treated by intrauterine transfusion and 50 per cent for those not treated in this way. The mortality directly attributable to the procedure was at least 20 per cent and did not take into account errors of selection nor accidents associated with amniocentesis.

Amniotic Fluid↗
PubMed1972

Liquor bilirubin levels and false prediction of severity in rhesus haemolytic disease.

Liquor bilirubin levels gave a false prediction of outcome for the fetus in 80 out of 716 rhesus-sensitized women referred for treatment during 1965-9. Trauma caused by amniocentesis seemed to be responsible for an increase in the severity of immunization in a significant proportion of cases. In addition, contamination of liquor samples by plasma, particularly fetal plasma, completely invalidated liquor bilirubin estimations. Errors in estimation of gestational length were also found to be associated with misleading results and a poor fetal prognosis.

Amniocentesis↗